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Insurance Claims Processing Jobs in Massachusetts

... life insurance, tax deferred savings accounts, 10 backup daycare days each year, short- and ... The Claims Specialist will timely and accurately process all claims from filing to closure in ...

Medical Billing Specialist

Holyoke, MA · On-site

$19.25 - $20.50/hr

Knowledge of insurance claims processing, payment posting, and denial follow-up * Familiarity with medical terminology, CPT/ICD codes, and billing procedures preferred * Strong attention to detail ...

Manage and process personal auto insurance claims of moderate complexity. * Review claim files and obtain any missing documentation needed to support claim resolution. * Communicate with ...

Auto PD - Adjuster Service Claims

Worcester, MA · Hybrid

$49K - $64K/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 ...

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 ...

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 ...

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 ...

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 ...

Ability to understand Central Insurance's policies and processes * Completes our AMD Claims Training Program * Possesses a change champion mindset to help facilitate the adoption of new tools and ...

Showing results 21-40

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 does an insurance claims processing do?

An insurance claims processor reviews and evaluates insurance claims to determine coverage eligibility and the amount payable. They verify information, process documentation, and communicate decisions to policyholders, often using claims management software. Attention to detail and knowledge of insurance policies are essential for this role.

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 in insurance or related fields. Relevant skills include attention to detail, communication, and familiarity with claims processing software. Gaining experience through internships or entry-level positions can improve job prospects, and some employers may require certification such as the Certified Claims Professional (CCP).

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 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.

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 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:
What cities in Massachusetts are hiring for Insurance Claims Processing jobs? Cities in Massachusetts with the most Insurance Claims Processing job openings:
Infographic showing various Insurance Claims Processing job openings in Massachusetts as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 21% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution.

Senior Manager, Stop Loss & Health Claims

Sun Life Financial

Wellesley Hills, MA • On-site, Remote

$68K - $102K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago


Sun Life Assurance Company of Canada rating

8.6

Company rating: 8.6 out of 10

Based on 18 frontline employees who took The Breakroom Quiz

88th of 304 rated insurance


Job description

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.


At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful.


When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives.


Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

Job Description:

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK.

The opportunity: The Senior Manager, Stop Loss and Health Claims leads our dynamic claims unit. In this critical role, you'll oversee complex claims operations, manage a high-performing team, and collaborate with key partners to drive our continued growth and excellence in customer service.

How you will contribute:

  • Lead Claims Operations: Direct the evaluation, investigation, negotiation, and settlement of complex claims, ensuring optimal balance between policyholder interests and company objectives.
  • Manage and Develop Staff: Supervise, mentor, and grow a talented claims team, overseeing work assignments, performance management, and professional development.
  • Optimize Processes: Monitor workflow, implement efficiencies, and ensure prompt, accurate claims processing to enhance operational effectiveness.
  • Collaborate with Partners: Work closely with third-party administrators, brokers, agents, policyholders, vendors, and legal counsel to maintain Sun Life's strong reputation and drive business growth.

What you will bring with you:

  • Ability to work with a diverse range of people
  • 5+ years of medical stop loss insurance or health insurance claims experience required, previous management/leadership experience preferred
  • Proven leadership skills and deep industry expertise
  • Strong analytical and problem-solving abilities
  • Experience in stakeholder management and customer-facing roles
  • In-depth knowledge of claims practices, state and federal laws
  • Excellent communication and negotiation skills
  • Ability to analyze and communicate complex data and trends
  • Proficiency with claims management systems and Sun Life products

Salary:

$68,200-$102,300

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!

We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email thebrightside@sunlife.comto request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Category:

Claims - Health & Dental

Posting End Date:

30/08/2026

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