DTS is looking for EDI Developer for our direct client Position in Indianapolis, IN Client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system ...
DTS is looking for EDI Developer for our direct client Position in Indianapolis, IN Client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system ...
Claims Advocate
Indianapolis, IN · On-site
The CA takes the initial loss report from our client, sets expectations about the claims process, files the claim with the insurance company, notes the claim file as needed during the life of the ...
Claims Advocate
Indianapolis, IN · On-site
The CA takes the initial loss report from our client, sets expectations about the claims process, files the claim with the insurance company, notes the claim file as needed during the life of the ...
State of Indiana Duration: 12+ Months Seeking an EDI expert to maintain and advance health insurance claims processing systems (ACAPS). The role involves supporting claims lifecycle from intake to ...
New
State of Indiana Duration: 12+ Months Seeking an EDI expert to maintain and advance health insurance claims processing systems (ACAPS). The role involves supporting claims lifecycle from intake to ...
New
Contract Role The Client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. The EDI Expert is responsible for maintaining the life cycle ...
Contract Role The Client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. The EDI Expert is responsible for maintaining the life cycle ...
Position Overview The client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. The EDI Expert is responsible for maintaining the life ...
New
Position Overview The client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. The EDI Expert is responsible for maintaining the life ...
New
Senior EDI Developer at IN
Indianapolis, IN · On-site
State of Indiana Duration: 12+ Months Seeking an EDI expert to maintain and advance health insurance claims processing systems (ACAPS). The role involves supporting claims lifecycle from intake to ...
New
Quick apply
Senior EDI Developer at IN
Indianapolis, IN · On-site
State of Indiana Duration: 12+ Months Seeking an EDI expert to maintain and advance health insurance claims processing systems (ACAPS). The role involves supporting claims lifecycle from intake to ...
New
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
Senior EDI Developer
Indianapolis, IN · On-site
Position Overview The client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. The EDI Expert is responsible for maintaining the life ...
Senior EDI Developer
Indianapolis, IN · On-site
Position Overview The client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. The EDI Expert is responsible for maintaining the life ...
As a Claims Specialist in the Shepherd family, you will assist the Truck Dealership Program service team and insurance advisors in the handling and processing of claims with Agency procedures and ...
As a Claims Specialist in the Shepherd family, you will assist the Truck Dealership Program service team and insurance advisors in the handling and processing of claims with Agency procedures and ...
Claims Rep - Clinic
East Chicago, IN · On-site
$18 - $26.37/hr
Under general supervision interacts daily with patients, insurances, and staff to identify and correct data errors. Performs claims processing tasks to ensure that claims are accepted in a timely ...
Claims Rep - Clinic
East Chicago, IN · On-site
$18 - $26.37/hr
Under general supervision interacts daily with patients, insurances, and staff to identify and correct data errors. Performs claims processing tasks to ensure that claims are accepted in a timely ...
Under general supervision interacts daily with patients, insurances, and staff to identify and correct data errors. Performs claims processing tasks to ensure that claims are accepted in a timely ...
Under general supervision interacts daily with patients, insurances, and staff to identify and correct data errors. Performs claims processing tasks to ensure that claims are accepted in a timely ...
Casualty Claims Specialist
Indianapolis, IN · On-site
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
Casualty Claims Specialist
Indianapolis, IN · On-site
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
Casualty Claims Specialist
Fort Wayne, IN · On-site
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
Casualty Claims Specialist
Fort Wayne, IN · On-site
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
Casualty Claims Specialist
Evansville, IN · On-site
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
Casualty Claims Specialist
Evansville, IN · On-site
At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to ... Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work ...
Strong understanding of insurance claims, denials, EOBs, and appeals processes * Experience working with commercial insurance, Medicare, and Medicaid claims * Excellent communication and problem ...
Strong understanding of insurance claims, denials, EOBs, and appeals processes * Experience working with commercial insurance, Medicare, and Medicaid claims * Excellent communication and problem ...
Seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. Bachelor's Degree in Computer Science or related fields with IT experience Database ...
New
Seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. Bachelor's Degree in Computer Science or related fields with IT experience Database ...
New
EDI Developer
Indianapolis, IN · On-site
Seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. Bachelor's Degree in Computer Science or related fields with IT experience Database ...
New
Quick apply
EDI Developer
Indianapolis, IN · On-site
Seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS. Bachelor's Degree in Computer Science or related fields with IT experience Database ...
New
Insurance Follow Up
Greenwood, IN · On-site
Strong understanding of insurance claims, denials, EOBs, and appeals processes * Experience working with commercial insurance, Medicare, and Medicaid claims * Excellent communication and problem ...
Insurance Follow Up
Greenwood, IN · On-site
Strong understanding of insurance claims, denials, EOBs, and appeals processes * Experience working with commercial insurance, Medicare, and Medicaid claims * Excellent communication and problem ...
Insurance Claims Processing information
What is insurance claims processing?
Insurance claims processing is the procedure by which insurance companies review, investigate, and settle claims made by policyholders. This process involves verifying the details of a claim, ensuring it meets the terms of the policy, and determining the appropriate payout or action. Claims processors handle documentation, communicate with claimants, and may work with other parties like adjusters or healthcare providers. The goal is to ensure claims are resolved efficiently, accurately, and fairly according to policy guidelines.
What are some common challenges faced in insurance claims processing, and how can new team members effectively manage them?
In insurance claims processing, new team members often encounter challenges such as handling high volumes of claims, interpreting complex policy language, and communicating effectively with policyholders and other stakeholders. To manage these challenges, it's important to develop strong organizational skills, stay detail-oriented, and proactively seek clarification when unsure about policy terms or procedures. Collaborating with experienced colleagues and taking advantage of ongoing training opportunities can also help new processors build confidence and efficiency in their daily tasks.
What is the difference between Insurance Claims Processing vs Insurance Adjuster?
| Aspect | Insurance Claims Processing | Insurance Adjuster |
|---|---|---|
| Credentials | Typically requires a high school diploma or equivalent; certifications like CPCU or AIC are common | Requires a high school diploma; certifications like AIC or state licensing often needed |
| Work Environment | Office-based, processing claims via computer systems | Field and office work, inspecting damages and interviewing claimants |
| Employer & Industry Usage | Insurance companies, third-party administrators | Insurance companies, independent adjusting firms |
| Primary Focus | Reviewing and processing insurance claims efficiently | Assessing damages and determining claim validity and payout |
While both roles are essential in the insurance industry, Insurance Claims Processing focuses on handling and managing claims paperwork, whereas Insurance Adjusters evaluate damages and determine claim settlements. Understanding these differences helps job seekers identify the right career path within the insurance sector.
What are the key skills and qualifications needed to thrive in Insurance Claims Processing, and why are they important?
To excel in Insurance Claims Processing, you need strong attention to detail, analytical abilities, and a foundational understanding of insurance policies or claims procedures, often supported by a high school diploma or associate degree. Familiarity with claims management software, databases, and sometimes industry certifications like AIC (Associate in Claims) is common. Effective communication, problem-solving skills, and the ability to manage stressful situations make someone stand out in this role. These competencies are critical for ensuring claims are processed accurately, efficiently, and in compliance with regulatory standards.
What are popular job titles related to Insurance Claims Processing jobs in Indiana? For Insurance Claims Processing jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Processing jobs in Indiana look for? The top searched job categories for Insurance Claims Processing jobs in Indiana are:
Job description
DTS is looking for EDI Developer for our direct client Position in Indianapolis, IN
Job Description:
Client is seeking an EDI expert in order to maintain and advance its health insurance claims processing system, ACAPS.Â
The EDI Expert is responsible for maintaining the life cycle of claims as they arrive from health providers at IDOH, are loaded into our database, are adjudicated based on state and national pricing standards, and as adjudication messages are generated and sent back to the originating provider. This position will work with the project manager, software developers, business analysts, and functional team members on the project activities. Â
Essential Duties / Responsibilities:Â
- Review update all documentation related to claims processing and EDI transactions
- Identify incompletely documented claims processing and EDI processes, and document them
- Work with development team as a SME as IDOH’s ACAPS system is rewritten in .Net
- Act as liaison between OTC team and the Children’s program area on claims processing issues
- Working with technical and functional staff on detailed business requirements, understanding business processes and technology, agency standards, federal and state policies to align with project’s goals.
- Write technical specifications based on conceptual design and stated business requirements.
- Test new and existing systems
- Ensure accurate and appropriate file exchanges with external trading partners and resolve EDI data transmission conflicts.
- Provide helpdesk level support for EDI claim transactions.
o             Provide support to healthcare providers who interact with IDOH’s CSHCS system
o             Assist in onboarding new providers
o             Assist in onboarding new clearinghouses
- Ability to work independently with less guidance and work with ISDH externals partners as needed.Â
Required / Desired Skills
Skill
Required / Desired
Amount
of Experience
Bachelor’s Degree in Computer Science or related fields with IT experience
Required
     ÂDatabase knowledge
Required
5
Years
Understanding EDI file formats (835, 837, 210)
Required
5
Years
Knowledge of HIPAA regulations
Required
Ability to solve complex troubleshooting issues
Required
Excellent verbal and written communication skills
Required
Health Industry experience
Highly desired
Knowledge of IBM Websphere (WTX)
Highly desired
Database/SQL experience
Highly desired
DTS offers excellent compensation package.
Contact:
Karun Sharma
Team Lead
Digital Technology Solutions