ZipRecruiter

Log In

1

Insurance Claims Processing Jobs in Washington (NOW HIRING)

System One

Healthcare EDI Claims Analyst

Columbia, MD · On-site

$52.96/hr

Investigate and resolve healthcare claims processing issues and incident tickets. * Analyze EDI 837 ... Experience working with healthcare payers, health plans, or insurance organizations. * Strong ...

Corvel

Senior Liability Claims Specialist

Rockville, MD · Hybrid

$61K - $98K/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 ...

Corvel

Senior Liability Claims Specialist

Rockville, MD · On-site

$61K - $98K/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 ...

Marriott

Claims Adjuster II

Bethesda, MD · On-site +1

Knowledge of claims processing. Preferred * Applicable industry licensing. * Associate in Claims ... insurance, adoption expense reimbursements, paid parental leave and educational assistance.

Marriott International

Claims Adjuster II

Bethesda, MD · On-site

$63K - $92K/yr

Knowledge of claims processing. Preferred * Applicable industry licensing. * Associate in Claims ... insurance, adoption expense reimbursements, paid parental leave and educational assistance.

Marriott

Claims Adjuster II

Bethesda, MD · On-site +1

Knowledge of claims processing. Preferred * Applicable industry licensing. * Associate in Claims ... insurance, adoption expense reimbursements, paid parental leave and educational assistance.

next page

Showing results 1-20

All JobsInsurance Claims Processing JobsInsurance Claims Processing Jobs in Washington

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 Washington? For Insurance Claims Processing jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Processing jobs in Washington look for? The top searched job categories for Insurance Claims Processing jobs in Washington are:
What cities in Washington are hiring for Insurance Claims Processing jobs? Cities in Washington with the most Insurance Claims Processing job openings:
Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Washington as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 21% Part Time, and 6% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution.

Healthcare Claims Operations Team Lead - Washington, DC (On-site)

Gainwell Technologies

Washington, DC • On-site

$50K - $55K/yr

Full-time

Medical, Life, Retirement, PTO

Re-posted 2 days ago

Gainwell Technologies rating

7.8

Company rating: 7.8 out of 10

Based on 78 frontline employees who took The Breakroom Quiz

135th of 242 rated software companies

Job description

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Summary
As a Healthcare Claims Operations Team Lead at Gainwell, you will lead a team responsible for medical claims processing, resolution, and financial reconciliation supporting Medicaid and Medicare programs.
You will oversee end-to-end healthcare claims operations, including claims adjudication, complex issue resolution, payment accuracy, and compliance with CMS guidelines. This role serves as a subject matter expert in health insurance claims workflows and financial processes, while driving operational efficiency, quality, and continuous improvement.
Your role in our mission
  • Lead, mentor, and develop a team supporting medical claims processing, adjudication, and resolution
  • Oversee the full lifecycle of healthcare claims, ensuring accuracy, timeliness, and service excellence
  • Resolve complex and escalated Medicaid and Medicare claims issues, including discrepancies and exceptions
  • Manage claims-related financial processes, including payments, reimbursements, adjustments, and reconciliations
  • Partner with cross-functional teams across finance, compliance, IT, and operations to optimize workflows and performance

What we're looking for
  • 5-7+ years of experience in medical claims, healthcare claims, or health insurance operations
  • Strong experience working with Medicaid and/or Medicare claims
  • Experience with end-to-end claims lifecycle, including adjudication, processing, and resolution
  • Knowledge of claims-related financial processes, including reconciliation, payments, and adjustments
  • Proven experience leading or supervising teams in a healthcare claims or insurance environment

What you should expect in this role
  • Onsite position located at Gainwell Technologies, 1111 19th St NW, Suite 1000, Washington, DC
  • Opportunity to lead high-impact healthcare claims operations supporting government-sponsored programs
  • A collaborative environment focused on operational excellence, compliance, and continuous improvement
  • Career growth within a company that values innovation, flexibility, and professional development
  • Exposure to cross-functional leadership and strategic initiatives across claims, finance, and compliance teams

*This posting is intended for pipelining. We will accept applications on an ongoing basis.
#LI-ONSITE
#LI-LS2
The pay range for this position is $50,000 - $55,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

What Gainwell Technologies employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Gainwell Technologies logo

About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

View All Gainwell Technologies Jobs

Apply