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Insurance Claims Processing Jobs in Virginia (NOW HIRING)

Kinsale Insurance

Associate Claims Examiner

Richmond, VA · On-site

$70K - $73K/yr

Kinsale Insurance has a proven track record of helping candidates like you build rewarding careers ... Conducting thorough investigations throughout all stages of the claims process. * Evaluating ...

Kinsale Insurance

Associate Claims Examiner

Richmond, VA · On-site

$70K - $73K/yr

Kinsale Insurance has a proven track record of helping candidates like you build rewarding careers ... Conducting thorough investigations throughout all stages of the claims process. * Evaluating ...

Brookfield

Sr Claims Specialist

Richmond, VA · On-site

... with our insured and brokers. * Analyzing claims forms, policies and endorsements, client ... Processing mail and prioritizing workload. * Completing telephone calls and written correspondence ...

Socket.dev

Lost Time Claims Specialist

Glen Allen, VA · On-site

$52K - $85K/yr

... process taking into consideration experience, qualifications, and overall fit for the role. The ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

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All JobsInsurance Claims Processing JobsInsurance Claims Processing Jobs in Virginia

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 Virginia?

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

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

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

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

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

Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 68% Full Time, 27% Part Time, and 4% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.

Claims Representative

Virginia Beach, VA • On-site

Blue Cross and Blue Shield of North Carolina
Insurance Services • 5 - 10K employees
Learn more about Blue Cross and Blue Shield of North Carolinaexternal

$41K - $66K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Posted yesterday

New

Blue Cross and Blue Shield of North Carolina rating

7.8

Company rating: 7.8 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

Job description

Job Description

We're hiring a Claims Representative to join the Claims Team! Under direct supervision, the Claims Representative reviews and timely adjudicates claims and administers them in accordance with contractual benefits and health care policies. The Claims Representative is responsible for managing daily work queues, quality of claims processed and final resolution. Also monitors claim turnaround times to assure all compliance guidelines are met as well as performance guarantees. Claims reviewed are for singular business segment and/or singular claims-provider type.

What You'll Do

  • Process, adjust or update various routine claims payments and payment errors for singular business segment and/or claims-provider type

  • Respond promptly and accurately to inquiries from Core Service, subscribers, providers, physicians and other insurance carriers regarding claims payments

  • Meet or exceed established quality and performance standards

  • Determine suspended claim resolution methods by reviewing benefit eligibility, claims history and other information

  • Identify system problems, including documentation of the issue, recommendation of potential solutions, referral to appropriate technical staff and follow-up to ensure resolution

  • Assist management by identifying and analyzing opportunities for improvements in BCBSNC processes, policies and services

  • May coordinate with other insurance carriers and Medicare to determine BCBSNC payment liability

  • Review claims for possible "fraud and abuse" and send to Special Investigations Unit for additional investigation

What You Bring

  • High school diploma or GED

  • 0-2 years of experience in related field.

Bonus Points (Preferred qualifications)

  • Data entry experience is a plus.

WhatYou'llGet

  • The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community

  • Work-life balance, flexibility, and the autonomy to do great work

  • Medical, dental, and vision coverage along with numerous health and wellness programs

  • Parental leave and support plus adoption and surrogacy assistance

  • Career development programs and tuition reimbursement for continued education

  • 401k match including an annual company contribution

  • Learn more

WhereYou'llWork

Our Hybrid Flex approach is builton presencewith a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a workplacethat'sflexible, connected, and future focused.

In a Hybrid-Flex role,you'llwork in the office at least two days a week for collaboration and connection. In a Remote Flex role,you'llwork virtually, with a few in-office visits each year for meaningful moments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$41,600.00 - $66,561.00

Skills

Claims Adjudication, Claims Analysis, Claims Management, Claims Processing, Claims Resolution, Claims Review, Customer Service, Documentations, Insurance, Insurance Claims, Medical Claims Processing, Medicare, Patient Care, Policy Knowledge, Process Improvements

_____________________________________________________________________
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

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