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Insurance Claims Processing Jobs in Rhode Island

Harris

RCM Manager

Carolina, RI · On-site

$50K - $60K/yr

Denial Management and Claims Resolution: o Oversee the medical claims denial management process ... insurance companies and clients as needed for complex healthcare claims. Team Leadership and ...

Brown University Health

Claims Follow Up Rep

Providence, RI · On-site +1

$19.97 - $32.96/hr

... re-process all denied claims to obtain timely reimbursement of each third-party claim and ensure ... EXPERIENCE One to three years of relevant experience in insurance follow-up of professional ...

Brown University Health

Claims Follow Up Rep

Providence, RI · On-site +1

$19.97 - $32.96/hr

... re-process all denied claims to obtain timely reimbursement of each third-party claim and ensure ... EXPERIENCE One to three years of relevant experience in insurance follow-up of professional ...

Brown University Health

Claims Follow Up Rep

Providence, RI · On-site +1

$19.97 - $32.96/hr

... re-process all denied claims to obtain timely reimbursement of each third-party claim and ensure ... One to three years of relevant experience in insurance follow-up of professional/hospital billing.

Brown University Health

Claims Follow Up Rep

Providence, RI · On-site +1

$19.97 - $32.96/hr

... re-process all denied claims to obtain timely reimbursement of each third-party claim and ensure ... EXPERIENCE One to three years of relevant experience in insurance follow-up of professional ...

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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 Rhode Island? For Insurance Claims Processing jobs in Rhode Island, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Processing jobs in Rhode Island look for? The top searched job categories for Insurance Claims Processing jobs in Rhode Island are:
Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Rhode Island as of June 2026, with employment types broken down into 91% Full Time, 1% Part Time, and 8% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution.
Ins Claims Specialist Medical Malpractice - Cranston, RI

Ins Claims Specialist Medical Malpractice - Cranston, RI

Diedre Moire Corp.

Cranston, RI • On-site

$100K - $140K/yr

Other

PTO

Posted 27 days ago

Job description

Ins Claims Specialist Medical Malpractice - Cranston, RI Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare _ . REMOTE - WORK FROM HOME MAY BE AVAILABLE Analyze and resolve complex or technically difficult medical malpractice claims within Company standards, industry best practices and specific client service requirements. • Analyze and process medical malpractice claims to determine exposure.

• Conduct or assign full investigation and report new events, claims, and legal actions. • Identify and investigate possible fraud, subrogation, contribution, recovery, and case management opportunities. • Calculate and assign timely and appropriate reserves and monitor adequacy throughout claim life.

• Recommend settlement strategies and negotiate claim settlement to designated authority level. • Bring structured settlement proposals as necessary to maximize settlement. • Coordinate legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices.

• Represent Company in depositions, mediations, and trial monitoring. • Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost. • Ensure claim files documented and claims coding is correct.

• Delegate work and mentor assigned staff. Competitive compensation package, annual bonuses, vacation time from start, fully covered benefits package, company laptop and cellphone, and chance to immediately impact the success of the company. Highly rated by current employees, former employees, and customers, this company has a history of success.

Growth opportunities in a career focused organization that rewards hard work, dedication, and excellence in performance. For complete details contact Greg Foss at: (609) 584-9000 ext 270 Or submit resume online at: http://dmc9.com/gbf/app.asp Or email to: 1000071019_10006796@najbcareers302.com Please reference #42971RI192 when responding. Diedre Moire Corporation Education Requirements: Bachelor Degree Minimum Experience Requirements: 5-10 years Job City Location: Cranston Job State Location: RI Job Country Location: USA Salary Range: $100,000 to $140,000 Diedre Moire Corporation, Inc.

diedremoire.com WE ARE AN EQUAL OPPORTUNITY EMPLOYER and our employment decisions are made without regard to race, color, religion, age, sex, national origin, handicap, disability or marital status. We reasonably accommodate individuals with handicaps, disabilities and bona fide religious beliefs. Jobs Career Position Hiring.

CONSIDERED EXPERIENCE INCLUDES: Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs #UnderwriterJobs DISCLAIMER: We will make every effort to consider applications for all available positions and shall use one or more of the contact methods and addresses indicated in resume or online application. Indicated location may be proximate or may be desirable point of embarkation for paid or unpaid relocation to another venue. Job descriptions may fit single or multiple presently available or anticipated positions and are NOT an offer of employment or contract implied or otherwise.

Described compensation is not definite nor precise and may be estimated and approximate and is negotiable depending on market conditions and candidate availability and other factors and is solely at the discretion of employers. Linguistics used herein may use First Person Singular and First Person Plural grammatical person construction for and with the meaning of Third Person Singular and Third Person Plural references. We reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.

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