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Insurance Claims Processing Jobs in Ohio (NOW HIRING)

Sweetwater Care

Regional Biller

Cleveland, OH · Remote

$60K - $80K/yr

Process patient billing and insurance claims in a timely and accurate manner * Maintain accurate and detailed records of patient billing and insurance claims * Identify and resolve billing-related ...

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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 Ohio?

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

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

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

Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Ohio 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.

Casualty Claims Specialist

Cincinnati, OH

First Chicago Insurance
Insurance Services • 51 - 200 employees
Learn more about First Chicago Insuranceexternal

Full-time

Medical, Dental, Retirement, PTO

Re-posted 22 days ago

First Chicago Insurance rating

5.7

Company rating: 5.7 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

At First Chicago Insurance Company, our employees are our biggest asset! It is our mission to attract and retain intelligent, motivated, ethical employees who strive for excellence and growth, and to keep those employees happy and engaged. We provide the tools and the support our employees need to grow both professionally and personally. We encourage self-improvement and celebrate success by rewarding ideas and results. We realize the strength of teamwork and its ability to join individuals together and push and pull each other, with a synergy that can only be found in groups of good people sharing ideas. Join in on the excitement and become part of our thriving organization!

We are seeking an experienced Casualty Claims Specialist!
The Casualty Claims Specialist will be responsible for investigating and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation.

The Casualty Claims Specialist will have the following duties and responsibilities:

  • Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss.
  • Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability status, and damages that are applicable for each claim.
  • Process Bodily Injury, and coverage claims in accordance with established office procedures.
  • Work closely with Third Parties, plaintiff counsel, Claim Director and Chief Operating Officer to determine necessary injury and coverage investigation.
  • Research case and statutory law in order to conduct proper claim investigation.
  • Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims.
  • Prepare and present claim evaluations for the appropriate settlement authority.
  • Maintain reasonable expense factors.
  • Handle other duties as assigned

QUALIFICATIONS REQUIRED:

  • 3-5 years in Casualty claims experience a MUST!
  • Knowledge of legal and medical terminology.
  • Excellent negotiation, communication, written, organizational and interpersonal skills.
  • Ability to pass written examinations where required by state statutes to become a licensed claims adjuster.
  • Proficiency in Microsoft Office products.

First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive:

  • Competitive Salaries
  • Commitment to your Training & Development
  • Medical and Dental
  • Telemedicine Benefit
  • 401k with a generous company match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement Training Programs
  • Wellness Program
  • Fun company sponsored events
  • And so much more!

Visit our company website at firstchicagoinsurance.com


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