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Insurance Claims Processing Jobs in Pennsylvania

Sovereign Insurance Group

Claims Specialist

Berwyn, PA · On-site

$80K - $100K/yr

This person in this position works closely with customers and insurance carriers, providing support and guidance to ensure a seamless experience throughout the claims process. Responsibilities

Sovereign Insurance Group

Claims Specialist

Berwyn, PA · On-site

$80K - $100K/yr

This person in this position works closely with customers and insurance carriers, providing support and guidance to ensure a seamless experience throughout the claims process. Responsibilities

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All JobsInsurance Claims Processing JobsInsurance Claims Processing Jobs in Pennsylvania

Insurance Claims Processing information

Is claims processing a stressful job?

Insurance claims processing can be stressful due to tight deadlines, high workload, and the need for accuracy in evaluating claims. The role often requires strong attention to detail, communication skills, and the ability to handle difficult or emotional situations with claimants. However, workload and stress levels can vary depending on the employer and specific job environment.

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.

How to get a job as a claims adjuster with no experience?

To become a claims adjuster with no experience, focus on obtaining relevant certifications such as the Property and Casualty (P&C) license, which is often required. Gaining entry-level positions or internships in insurance companies can also help build industry knowledge and skills like communication and attention to detail, increasing your chances of starting a claims adjusting career.

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, 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 does an insurance claims processor 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 specialized software. Strong 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 Pennsylvania? For Insurance Claims Processing jobs in Pennsylvania, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Processing jobs in Pennsylvania look for? The top searched job categories for Insurance Claims Processing jobs in Pennsylvania are:
What cities in Pennsylvania are hiring for Insurance Claims Processing jobs? Cities in Pennsylvania with the most Insurance Claims Processing job openings:
Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Pennsylvania as of July 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Claims & Denials Analyst

Lawall Prosthetic and Orthotic Services

Langhorne, PA

Full-time

Posted 12 days ago

Job description

Claims amp; Denials Analyst - full-time - in-office - Langhorne, PA - M-F, 8am to 4:30pm
We’re a fast-growing, employee-friendly prosthetics and orthotics company seeking a Claims amp; Denials Analyst to join our dedicated team in Langhorne.
This is a great opportunity for someone with a positive attitude, strong attention to detail, and some experience with health insurance claims—especially if you’re eager to learn and grow in a meaningful healthcare environment.
*This is not a remote opportunity.
Why You’ll Love Working With Us:
  • Supportive, team-oriented culture
  • Safe, clean, and friendly office environment
  • Opportunities for growth and on-the-job training
  • A chance to help patients receive life-changing care
What You’ll Do:
You’ll play a key role in making sure our patients' health insurance claims are submitted, processed, and resolved smoothly. Responsibilities include:
  • Preparing and reviewing patient documentation and claims
  • Verifying insurance eligibility and benefit coverage
  • Ensuring accurate coding and billing data
  • Submitting claims to private insurers and following up regularly
  • Investigating denials and working error/reject reports
  • Updating patient and insurance information in our systems
  • Collaborating with teammates to resolve billing issues quickly and correctly
What We’re Looking For:
We’re looking for someone who is:
  • Friendly, dependable, and eager to learn
  • A clear communicator with strong phone and computer skills
  • Computer-savvy, with experience using EMR or patient billing systems
  • Detail-oriented and organized
  • Able to work independently and manage priorities effectively
  • Comfortable handling sensitive information with professionalism
Qualifications:
  • High school diploma or GED required
  • 2 years of college or equivalent work experience preferred
  • 2 years of recent experience in healthcare accounts receivable
  • Thorough knowledge of private insurance claims processes
  • Proficient in Microsoft Outlook, Word, and Excel
  • Experience with EMR and patient billing software strongly preferred
Bonus Points If You:
  • Have some experience processing claims for respiratory DME
  • Have experience processing claims for orthotics and prosthetics
  • Enjoy solving puzzles and getting things “done right”
  • Bring a positive, team-first attitude every day
We offer competitive pay, benefits, and a great place to grow your career.

If you’re someone who takes pride in doing meaningful work and helping people access the care they need, we want to hear from you.
This is a drug-free workplace. Employment is contingent upon a background check and drug screening.

Apply