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Insurance Claims Processing Jobs in Tennessee (NOW HIRING)

American Health Partners

Claims Auditor

Franklin, TN · Hybrid

Two (2) years' experience with complex claims processing and/or auditing experience in the health insurance industry or medical health care delivery system * Two (2) years' experience in managed ...

RemX

Be Seen First

Medical Billing Insurance Follow Up Specialist

Knoxville, TN · On-site

$16 - $18/hr

Experience working with insurance carriers and claims processing * Strong analytical and problem-solving skills * Proficiency in EMR/EHR systems and Microsoft Office applications * Excellent ...

HomeFirst Agency

Claims Adjuster

Maryville, TN · On-site +1

... of claims, and explain the claims process and decisions. JOBFUNCTIONS ... Reviews insurance policies to determine coverageby working with Claims Trainers and ...

HomeFirst Agency

Claims Adjuster

Maryville, TN · On-site

Reviews, partners, and processes property damage claims submitted by policyholders. * Reviews insurance policies to determine coverage by working with Claims Trainers and leadership to interpret and ...

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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 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 Tennessee?

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

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

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

What cities in Tennessee are hiring for Insurance Claims Processing jobs?

Cities in Tennessee with the most Insurance Claims Processing job openings:

Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Tennessee as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 94% Physical, 3% Hybrid, and 3% Remote job distribution.

Dental Claims Coordinator- Special Needs Clinic

The University of Tennessee

Memphis, TN

$19.67/hr

Full-time

Medical, Dental

Re-posted 21 days ago

Job description

Market Range:  06        
Hiring Salary: $19.67/Hourly 

JOB SUMMARY/ESSENTIAL JOB FUNCTIONS: 

The Dental Claims Coordinator for the Special Needs Clinic oversees all dental insurance billing, claims processing, and provider credentialing for AEGD, UDP, and Special Needs Clinic. This position ensures accurate, timely claims and pre-authorizations, with a strong focus on services commonly required by patients with special health care needs such as hospital-based dentistry, sedation, and multidisciplinary treatment. This position serves as the clinic's subject matter expert on CDT coding, payer requirements, and documentation standards for insurance.

EDUCATION:

 High School Diploma or GED. (TRANSCRIPT REQUIRED)

EXPERIENCE: 

Four (4) years of public and private dental claims processing; OR Associate's Degree and two (2) years of public and private dental claims processing. 

KNOWLEDGE, SKILLS, AND ABILITIES:

  • Ability to organize and prioritize work to meet competing deadlines. 
  • Knowledge of special needs patient population guidelines, regulations, policy, and procedures 
  • Knowledge of public and private dental insurance billing policies.
  • Ability to manage multiple job priorities and tasks efficiently, effectively, and accurately while demonstrating close attention to detail.
  • Expert knowledge of dental terminology, treatment planning, CDT coding, accounts receivable and collections processes.
  • Ability to communicate professionally and courteously with faculty, residents, students, patients and staff. 
  • Ability to identify, research and/or resolve financial conflicts with insurance companies and patient accounts. 
  1. Prepares and submits insurance claims and pre-authorizations (electronic and paper); monitors all unsubmitted or denied claims. 
  2. Identifies and resolves payment issues proactively, coordinating with payers to obtain claim approvals.
  3. Audits patient records for accurate financial and CDT coding documentation; initiates corrections and communicates with providers to ensure compliant submissions.
  4. Collaborates with the hospital to create a streamlined process (create and monitor PAs, insurance coordination, and hospital coordination). 
  5. Assists students, residents, and staff in understanding insurance protocols.
  6. Maintain up-to-date knowledge of CDT coding, Medicaid/Medicare rules, and payer regulations for dentistry.
  7. Explains treatment costs and insurance coverage. 
  8. Performs other duties as assigned.

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