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Insurance Claims Processing Jobs in Massachusetts

The CCS Companies

Insurance Recovery Analyst

Norwood, MA · On-site

$24 - $28/hr

... claims processing systems. * Knowledge of medical and insurance terminology. * Knowledge of ... coordination of benefits. * Working knowledge of FACS (ClaimAssists host system) or comparable ...

HADAR DENTAL LLC

Dental Office Receptionist

Lexington, MA · On-site

$18 - $23/hr (+ commission)

You must have working knowledge of computers for word processing, scheduling, insurance claims processing and records management. You must have effective verbal skills to communicate with patients ...

HADAR DENTAL LLC

Dental Office Receptionist

Lexington, MA · On-site

$18 - $23/hr (+ commission)

You must have working knowledge of computers for word processing, scheduling, insurance claims processing and records management. You must have effective verbal skills to communicate with patients ...

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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.

TPA Claims Specialist II

USI Holdings Corporation

Braintree, MA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago

Job description

Description and Requirements
Must have Rhode Island experience claims experience. Other areas also needed, MA, VT etc.
General Description: Adjuster of lost and non-lost time claims for workers compensation.
Responsibilities:
  • Advanced Knowledge of claims function and processes.
  • Ability to effectively communicate with internal and external customers.
  • Strong understanding of workers compensation or disability claims management, strategies, resolution techniques and adjusting.
  • Technical capability to enter first reports of injury and to adjust lost time and non lost time claims utilizing the features of the TPA claim management systems.
  • Participates in claim advocacy and negotiations, including claim denials, reserving files, and claim reporting, issuing payments, attending hearings, conciliations or mediations and filing of state forms.
  • Determine compensability of the claim as it relates to the worker compensation jurisdiction.
  • Review and approval of loss time, medical services and expenses to be paid of the claims file.
  • Plan and attend claim reviews with clients, carriers and auditors.
  • Ability to identify client issues, build a plan towards resolution, execute and manage internal and external expectations effectively.
  • Analyzes claims based on the TPA best practices as outlined in the "Policy and Procedures" manual.

Knowledge, Skills and Abilities:
  • Ideal candidate will have a minimum 5 years of claims adjusting experience.
  • College degree preferred but high school diploma or graduate equivalent degree required.
  • Proficient-to-expert in MS Office suite of products.
  • Must be licensed in all jurisdictions handled.
  • Superior written and oral communication skills.
  • Ability to work well in a team environment.
  • Must have strong analytical thinking and problem-solving skills.
  • Strong organizational skills required.
  • Strong negotiation skills required.

#LI-NM2
Why USI?
With approximately $3 billion in revenue and over 10,500 associates across approximately 200 offices nationwide, USI is one of the largest insurance brokerage and consulting firms in the world. At USI, we have created one of the most dynamic personal and professional development cultures in the industry. We invest heavily in our associates, and we take pride in celebrating their growth and success through our one-of-a-kind employee reward and recognition programs.
Unrivaled Resources and Support
What truly distinguishes USI as a premier insurance brokerage and consulting firm is the USI ONE Advantage®, a game-changing value proposition that delivers to clients a robust set of risk management and benefit solutions with bottom-line financial impact. USI ONE® represents Omni, Network, Enterprise-the three key elements that set USI apart from the competition. Through USI ONE, we develop strategic, timely, and effective risk management and benefit programs in terms that are easy to understand, and we demonstrate how the solutions can have a positive economic impact.
Industry-Leading Programs, Rewards, and Recognition
In addition to competitive pay, incentives, and benefits, USI recognizes associates through our Summit Awards program, rewarding excellence in those who build our brand each day. USI offers employee programs that recognize outstanding achievement and help our associates lead healthy, productive lives. We turn care into action with our award-winning wellness program, college scholarships for associates' children, and financial help in times of need.
Deep Community Engagement
We are committed to giving back to our local communities and supporting a culture of environmental sustainability. From sharing our time, talent, and resources to support local non-profit organizations, animal shelters, and environmental beautification and restoration projects - to partnering with eco-conscious vendors and taking steps to reduce our own environmental footprint - we're working together as ONE to build a better future.
Committed to a Diverse and Inclusive Workplace
Our award-winning I'm With U diversity and inclusion program educates our associates to help them better understand and serve our clients, prospects, fellow team members, and local communities through curated education and training resources, employee support programs, and community outreach initiatives to build a more diverse, equitable, and inclusive culture.
Nationally Recognized as a Top Insurance Employer
  • Recognized as one of Insurance Business America's Top Insurance Employers eight consecutive years (2018-2025).
  • Named to Business Insurance's annual list of the Best Places to Work in Insurance six years in a row (2020-2025).
  • Named to Fortune's Best Workplaces in Financial Services & Insurance list for the last two years (2024-2025).
  • Certified as a Great Place To Work two years in a row (2024-2025).

Visit our Awards and Accolades page for a complete list of our latest industry awards and recognitions!
USI is committed to providing a full-suite of competitive benefits for our growing population and its diverse needs. We offer a wide range of health, welfare and financial benefits including medical, wellness, dental and vision, 401(k), flexible spending and health savings accounts, short and long-term disability, life insurance and other unique employer-sponsored and voluntary programs. USI also offers a generous paid time off policy, paid family leave benefit as well as paid holiday time.
$57,000 - $77,000

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