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Insurance Claims Processing Jobs in Massachusetts

RiverStone Management Ltd.

Claims Analyst

Beverly, MA · On-site

$66 - $110/hr

... processes. Responsibilities * Analyze claims data across managed portfolios to identify trends ... Solid understanding of insurance and/or reinsurance business models, with exposure to claims ...

New

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Auto PD - Adjuster Service Claims

Howell, MI · Hybrid

$46K - $60K/yr

Our Claims team is currently seeking an Auto PD Adjuster - Service Claims. This is a full-time, ... Knowledge of insurance products, processes, and relevant laws. * Learn and handle negotiations ...

Hiscox

Complex Claims Specialist-MPL

Boston, MA · Hybrid

This includes, but is not limited to, insurance agents, property managers, tax preparers, and various consultants. This role is responsible for all aspects of the claims and litigation process ...

Hiscox

Complex Claims Specialist-MPL

Boston, MA · Hybrid

This includes, but is not limited to, insurance agents, property managers, tax preparers, and various consultants. This role is responsible for all aspects of the claims and litigation process ...

Sedgwick

Claims Representative , Auto

Boston, MA · On-site

$50K/yr

Communicates claim action/processing with insured, client, and agent or broker when appropriate ... Performs coverage, liability, and damage analysis on all claims assignments. * Performs other ...

Sedgwick

Claims Representative , Auto

Springfield, MA · On-site

$50K/yr

Communicates claim action/processing with insured, client, and agent or broker when appropriate ... Performs coverage, liability, and damage analysis on all claims assignments. * Performs other ...

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Showing results 21-40

All JobsInsurance Claims Processing JobsInsurance Claims Processing Jobs in Massachusetts

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 the key skills and qualifications needed to thrive in insurance claims processing?

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 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?

AspectInsurance Claims ProcessingInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; certifications like CPCU or AIC are commonRequires a high school diploma; certifications like AIC or state licensing often needed
Work EnvironmentOffice-based, processing claims via computer systemsField and office work, inspecting damages and interviewing claimants
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary FocusReviewing and processing insurance claims efficientlyAssessing 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.

How to get a job as an insurance claims processor?

To become an insurance claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary training or certifications in insurance or claims processing. Relevant skills include attention to detail, communication, and familiarity with claims management software. Gaining experience through internships or entry-level positions can improve job prospects, and some employers may require background checks or specific licensing depending on the state or company policies.

Is insurance claims processing a stressful job?

Insurance claims processing can be a stressful job due to tight deadlines, high workload, and the need for accuracy in evaluating claims. It often requires strong attention to detail, communication skills, and the ability to handle difficult customer interactions, which can contribute to job-related stress.

What does an insurance claims processing do?

An insurance claims processor reviews and evaluates insurance claims to determine coverage and payout amounts. They verify policy details, gather necessary documentation, and ensure claims are processed accurately and efficiently, often using claims management software. Attention to detail and knowledge of insurance policies are essential for this role.

What are popular job titles related to Insurance Claims Processing jobs in Massachusetts?

For Insurance Claims Processing jobs in Massachusetts, the most frequently searched job titles are:

What job categories do people searching Insurance Claims Processing jobs in Massachusetts look for?

The top searched job categories for Insurance Claims Processing jobs in Massachusetts are:

Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Massachusetts as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.

Claims Senior MedPay Adjuster

American Automobile Association (AAA)

Boston, MA • On-site, Remote

$35.94 - $47.87/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 26 days ago

AAA The Auto Club Group rating

7.4

Company rating: 7.4 out of 10

Based on 283 frontline employees who took The Breakroom Quiz

236th of 315 rated insurance

Job description

Claims Senior MedPay Adjuster

Job Summary
The Claims Senior Medpay Adjuster handles moderate to high complexity Auto claims matters involving material damage, property and / or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include liability investigation, coverage evaluation, and negotiation of moderate to high-complexity claims. Employs discretion and independent judgment to ensure compliance with state and federal law, and with established company, technical, and customer service best practices.
Job Duties

  • Communicate and interact with a variety of individuals including insureds and claimants. Explain benefits, coverages, fault and claims process either verbally or in writing in compliance with regulatory and statutory requirements. Recognize and appropriately address coverage issues.
  • Conduct phone investigations to determine liability and damages. Identify and obtain statements from insureds, claimants and witnesses. Verify and resolve coverage by gathering necessary information to ensure policy applicability.
  • Evaluate and determine claim values upon receipt and assessment of property, bodily injury and liability data.
  • Negotiate within settlement authority with insureds and claimants to resolve first and third party claims.
  • Update database production reports, document and update claim files via company systems, i.e. CACS, HUON, HOC, GUIDEWIRE, etc.
  • Control expenses for areas of responsibility.
  • Verify and interpret / resolve coverage by gathering necessary information to ensure policy applicability. Coordinate with internal and external departments as required.
  • Independently resolve claim exposures within level of authority.
  • Respond quickly to customer needs and problems.
  • May attend and participate in legal proceedings.


Qualifications

  • Bachelors Equivalent combination of education and experience Preferred
  • 7-9 years Prior claims handling experience. Required
  • 7-9 years Property, Auto, Casualty or relevant claims administration experience. Preferred
  • Comprehensive knowledge of claims administration best practices and procedures.
  • Comprehensive knowledge of building and vehicle repair procedures and third-party liability issues.
  • Extensive knowledge of insurance, fault assessment, negligence and subrogation principles required.
  • Advanced knowledge of Microsoft Office suite, general computer software and claims software.
  • Advanced organization and planning recognition skills required.
  • Advanced oral and written communication skills required.
  • Advanced interpersonal skills required.
  • Advanced leadership skills among peers required.
  • Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required
  • An insurance/claims adjuster license may be required for claims administration in specific states.


Travel Requirements

  • Occasional travel to off-site business meetings or conferences. (5% proficiency)

The starting pay range for this position is $35.94 - $47.87 per hour. Additionally, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance.

Remarkable benefits:

Health coverage for medical, dental, vision

401(K) saving plans with company match AND Pension

Tuition assistance

Floating holidays and PTO for community volunteer programs

Paid parental leave

Wellness programs

Employee discounts (membership, insurance,

travel, entertainment, services and more!)

Auto Club Enterprises is the largest club within the national AAA federation. We have nearly 17,000 employees in 24 states helping more than 18 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity - we win. All of Us! With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

"Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value."

AAA is an Equal Opportunity Employer

Our organization participates in E-Verify

What AAA The Auto Club Group employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

American Automobile Association logo

About American Automobile Association

Sourced by ZipRecruiter

The American Automobile Association (AAA), headquartered in Heathrow, Florida, USA, is a reputable force in the automotive and insurance industry. Originating in 1902, it began as a coalition of motor clubs with the common goal of providing better roads and travel conditions for motorists. Today, AAA is a comprehensive, multifaceted organization that offers a range of services, including roadside assistance, auto repair services, travel agency services, and diverse insurance products - Auto, Home, Life and more. A significant principle for AAA is to continuously deliver value to their 61 million members through safety, security and peace of mind. The company's mission and core values focus on championing its members' rights and interests, advocating innovation, integrity, teamwork and respect.

Industry

Non-profits

Company size

10,000+ Employees

Headquarters location

Heathrow, FL, US

Year founded

1902

Social media

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