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Insurance Claims Processing Jobs in Portland, ME

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Insurance Claims Processing information

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$12

$22

$34

How much do insurance claims processing jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for insurance claims processing in Portland, ME is $22.85, according to ZipRecruiter salary data. Most workers in this role earn between $18.70 and $26.06 per hour, depending on experience, location, and employer.

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 Portland, ME? For Insurance Claims Processing jobs in Portland, ME, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Processing jobs in Portland, ME look for? The top searched job categories for Insurance Claims Processing jobs in Portland, ME are:
Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Portland, ME as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $47,535 per year, or $22.9 per hour.

Pharmacy Billing Specialist - On-Site

Guardian Pharmacy LLC

Brunswick, ME • On-site

$22/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 11 days ago

Job description

Job Opportunity at Guardian Pharmacy of Maine

Guardian Pharmacy of Maine, a member of the Guardian family of pharmacies, has an exciting opportunity for you to join our rapidly growing team in Brunswick, Maine. We're reimagining medication management and transforming care.

Our core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs. With our comprehensive suite of tech-enabled pharmacy services and a dedicated team of professionals committed to enriching the lives of those we serve, we are redefining how pharmacy care is delivered.

We offer an opportunity to learn and grow your career in a fast-paced, diverse, and inclusive environment. If you are looking for a challenging, team-oriented environment in which you can put your expertise to work, then this is the place for you.

Schedule: Must be flexible between the hours of 6 am - 7 pm

Pay range: $22 per hour

Responsibilities include processing customer bills and insurance claims in an accurate and timely manner, assisting with all daily and month-end billing functions, providing excellent customer service to patients, caregivers, medical providers and insurance carriers.

Required attributes:

  • Work Ethic/Integrity – must possess intrinsic drive to excel coupled with values in line with company philosophy
  • Relational – ability to build relationships with business unit management and become "trusted advisor."
  • Strategy and Planning – ability to think ahead, plan and manage time efficiently.
  • Problem Solving – ability to analyze causes and solve problems at functional level.
  • Team Oriented – ability to work effectively and collaboratively with all team members.

Essential job functions include:

  • Research and establish patient eligibility coverage with insurance providers including private individuals and/or government entities.
  • Maintain and continually audit patient files and corresponding documentation necessary to defend third party audits and ensure payer and company compliance.
  • Provide assistance and timely response to all billing customer inquiries via phone or electronic communications.
  • Provide guidance and support to resident or responsible party by running Medicare plan comparisons during open enrollment and special enrollment periods.
  • Responsible for completion of daily census, admit, discharge, and room changes for the facilities assigned.
  • Process patient payments, returns, and credits. Transmit individual credit card payments as needed.
  • May pursue payment from delinquent accounts and make payment arrangements.
  • Research, identify and organize requested audit documentation in timely manner.
  • Perform prescription claims adjudication including communication with insurance companies regarding rejected claims, eligibility, prior authorizations or other issues as needed. Make corrections as needed and rebill claims as necessary.
  • Develop knowledge and understanding in pharmacy facility billing requirements (Medicare, Medicaid, Prescription Drug Plans (PDPs) and Third-Party Insurances)
  • Develop proficiency in the utilization of pharmacy information systems to meet operational needs and regulatory requirements. This includes using pharmacy systems to process prior authorizations, resolve rejections, produce various reports as necessary, and complete billing functions.
  • Rotate through other departments to gain working/functional knowledge of other department workflows.
  • Follow all applicable government regulations including HIPAA.
  • Work as a collaborative team member to meet the service goals of the pharmacy.
  • Other essential functions and duties may be assigned as needed.

Education and/or certifications:

  • High School Diploma or GED required.
  • Pharmacy Technician license/certification/registration per state requirements; National Certification preferred (PTCB) may be required (pharmacy specific).

Skills and qualifications:

  • 1+ years of related experience
  • Advanced computer skills; pharmacy information system experience preferred.
  • Ability to work independently and deliver to deadlines.
  • Great attention to detail and accuracy
  • Ability to excel in a fast-paced, team-oriented environment working on multiple tasks simultaneously, while adhering to strict deadlines
  • Quality minded; motivated to seek out errors and inquire about inaccuracies.

Work environment:

  • The noise level in the work environment is usually low to moderate.
  • Due to the collaborative nature of the business and the need to service customers, the employee must be able to interact effectively with others in an office environment, manage conflict, and handle stressful situations and deadlines.
  • Requires desk work in office environment.
  • Ability to work flexible hours.

What We Offer:

Guardian provides employees with a comprehensive Total Rewards package, supporting our core value of, "Treat others as you would like to be treated." Compensation & Financial

  • Competitive pay
  • 401(k) with company match

Family, Health & Insurance Benefits (Full-Time employees working 30+ hours/week only)

  • Medical, Dental and Vision
  • Health Savings Accounts and Flexible Spending Accounts
  • Company-paid Basic Life and Accidental Death & Dismemberment
  • Company-paid Long-Term Disability and optional Short-Term Disability
  • Voluntary Employee and Dependent Life, Accident and Critical Illness
  • Dependent Care Flexible Spending Accounts

Wellbeing

  • Employee Assistance Program (EAP)
  • Guardian Angels (Employee assistance fund)

Time Off

  • Paid holidays and sick days
  • Generous vacation benefits based on years of service

The Guardian Difference

Our clients require pharmacy services that aren't "cookie cutter." That's why every Guardian pharmacy is locally operated and empowered with the autonomy to tailor their business to meet their clients' needs.

Our corporate support offices, based in Atlanta, Ga., provide services such as human resources, business intelligence, legal, and marketing to promote the success of each Guardian location.

Regardless of your role at Guardian, your voice and talents matter. Because healthcare is an ever-changing industry, we encourage innovative thinking, intellectual curiosity, and diverse viewpoints to ensure we stay competitive in today's dynamic business environment.

At Guardian, we are dedicated to fostering and advancing a diverse and inclusive workforce.

Join us to discover what your best work truly looks like.

Apply