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Insurance Claims Processor Jobs in Georgia (NOW HIRING)

HealthONE

Claims Processor II

Dalton, GA · On-site

$15 - $19/hr

The Claims Processor II will accurately interpret benefit and policy provisions applicable to fully-insured plan members and review claims to determine coverage based on contract, provider status ...

HealthOne Alliance

Claims Processor II

Dalton, GA · On-site

$15 - $19/hr

The Claims Processor II will accurately interpret benefit and policy provisions applicable to fully-insured plan members and review claims to determine coverage based on contract, provider status ...

HealthOne Alliance

Claims Processor II

Dalton, GA · On-site

$15 - $19/hr

The Claims Processor II will accurately interpret benefit and policy provisions applicable to fully-insured plan members and review claims to determine coverage based on contract, provider status ...

HealthOne Alliance

Claims Processor II

Dalton, GA · On-site

$15 - $19/hr

The Claims Processor II will accurately interpret benefit and policy provisions applicable to fully-insured plan members and review claims to determine coverage based on contract, provider status ...

Karna, LLC

$20 - $25/hr

Ability to interpret and apply insurance program policies and government regulations effectively. * Excellent written and verbal communication skills. * Proficient in Microsoft Office Suite (Word ...

KARNA LLC

$20 - $25/hr

Ability to interpret and apply insurance program policies and government regulations effectively. * Excellent written and verbal communication skills. * Proficient in Microsoft Office Suite (Word ...

Parker's Kitchen

Claims Specialist

Savannah, GA · On-site

Notify insurance carriers of new claims and serve as the primary point of contact throughout the claims process. * Assist injured employees throughout the claims process, including coordinating ...

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All JobsInsurance Claims Processor JobsInsurance Claims Processor Jobs in Georgia

Insurance Claims Processor information

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How much do insurance claims processor jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for insurance claims processor in Georgia is $18.86, according to ZipRecruiter salary data. Most workers in this role earn between $15.43 and $21.54 per hour, depending on experience, location, and employer.

What does an insurance claims processor do?

An Insurance Claims Processor reviews and handles insurance claims submitted by policyholders. Their primary responsibilities include verifying information, ensuring all necessary documentation is provided, and assessing claims for accuracy and compliance with policy guidelines. They communicate with policyholders, adjusters, and healthcare providers to gather additional information if needed, and determine how much the insurance company should pay out. The role is essential for ensuring claims are processed efficiently and fairly, maintaining customer satisfaction, and preventing fraud.

What are the key skills and qualifications needed to thrive as an insurance claims processor, and why are they important?

To thrive as an Insurance Claims Processor, you need strong attention to detail, knowledge of insurance policies and regulations, and typically a high school diploma or equivalent. Familiarity with claims management software, electronic databases, and sometimes certifications like the Associate in Claims (AIC) are common requirements. Excellent organizational skills, clear communication, and problem-solving abilities help you stand out in this role. These skills ensure accurate claim processing, effective customer service, and compliance with industry standards.

What are some common challenges faced by insurance claims processors, and how can they be managed effectively?

Insurance Claims Processors often encounter challenges such as managing high volumes of claims, navigating complex policy details, and meeting strict deadlines. Staying organized and detail-oriented is key to ensuring accuracy and timely processing. Effective communication with policyholders, adjusters, and other team members also helps resolve discrepancies quickly and improves overall workflow. Many employers provide ongoing training and support to help processors stay current on regulations and best practices, which can further ease these challenges.

What is the difference between Insurance Claims Processor vs Insurance Claims Adjuster?

AspectInsurance Claims ProcessorInsurance Claims Adjuster
CredentialsTypically requires a high school diploma or equivalent; certifications like CPCU or AIC are a plusRequires a high school diploma; often holds certifications such as AIC or CPCU
Work EnvironmentOffice setting, processing claims dataField and office work, investigating claims
Employer & IndustryInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary FocusProcessing and data entry of claimsInvestigating, evaluating, and settling claims

While both roles are essential in the insurance industry, Claims Processors focus on handling claim data and documentation, whereas Claims Adjusters investigate and determine claim validity and settlement amounts. Understanding these differences helps job seekers identify the right career path within insurance claims roles.

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 education or relevant certifications. Experience with computer software, attention to detail, and strong organizational skills are important, and familiarity with insurance policies and claims processing systems can improve job prospects.

Is an insurance claims processor job in demand?

The demand for insurance claims processors remains steady due to the ongoing need for claims management in the insurance industry. Employment is expected to grow at a rate similar to the average for all occupations, with opportunities increasing as insurance companies seek skilled workers familiar with claims processing software and regulations.

Is claims processing a stressful job?

Claims processing as an insurance claims processor can be stressful due to tight deadlines, high workload, and the need for accuracy in evaluating claims. The role often requires attention to detail, communication skills, and the ability to handle sensitive information, which can contribute to job-related stress levels.

What are popular job titles related to Insurance Claims Processor jobs in Georgia?

For Insurance Claims Processor jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Insurance Claims Processor jobs in Georgia look for?

The top searched job categories for Insurance Claims Processor jobs in Georgia are:

What cities in Georgia are hiring for Insurance Claims Processor jobs?

Cities in Georgia with the most Insurance Claims Processor job openings:

What are popular job titles related to Insurance Claims Processor jobs in GA?

For Insurance Claims Processor jobs in GA, the most frequently searched job titles are:

Insurance Claims Processor jobs near you
Infographic showing various Insurance Claims Processor job openings in Georgia as of August 2026, with employment types broken down into 1% As Needed, 68% Full Time, 19% Part Time, 9% Contract, and 3% Nights. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $39,231 per year, or $18.9 per hour.

Claims Processor II

HealthONE

Dalton, GA • On-site

$15 - $19/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago

Job description

Claims Processor II

Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors. HealthOne is guided by a cultural framework that embodies our values and drives our decisions. As a company our purpose is to care for people by connecting them to resources that help protect them in health related situations. We fulfill our purpose by filtering our decisions through a lens of asking, "Is what we are about to do ethical, empathetic, economical, and efficient?". By caring for people, we are welcoming, authentic, truthful, consistent, and humble. We are continuously looking for ways to improve our process and how we get things done. HealthOne seeks individuals with integrity and heart to embody our values. Whether you're starting your career or looking to develop additional skills to reach your full potential, HealthOne provides the means to help you achieve your goals.

Job Purpose: The Claims Processor II is responsible for accurate and timely processing of both professional and institutional medical claims pended for manual adjudication in assigned Workflow roles. The Claims Processor II will accurately interpret benefit and policy provisions applicable to fully-insured plan members and review claims to determine coverage based on contract, provider status, and claims processing guidelines. The incumbent must meet quality and productivity standards.

Essential Job Duties:

  • Reviews and adjudicates claims up to specified dollar limits
  • Processes claims within performance guidelines of the department, including quality and timeliness
  • Works with and understands Company benefit plans
  • Understands provider contracts
  • Examines and interprets all relevant documents included with the claims
  • Responds to claim-specific questions, as applicable
  • Partners with leadership on any questionable claim activity
  • Understands logic of standard medical coding (i.e. CPT, ICD-10, HCPCS, etc.)
  • Determines accurate payment criteria for clearing pended claims based on defined Policy and Procedures
  • Researches claim edits to determine appropriate benefit application utilizing established criteria, applies physician contract pricing as needed for claims
  • Works high volume of repetitive claims
  • Identifies claims with inaccurate data or claims that require review by appropriate team members
  • Contributes positively as a team player
  • Completes special projects as assigned and supports other Claims Department team members in assigned projects
  • Complies with all departmental and Company policies and procedures
  • Maintains regular and predictable attendance
  • Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
  • Works to encourage and promote Company culture throughout the organization
  • Other duties as may be assigned

Qualifications:

  • High School Diploma or GED required
  • Associates or Bachelor's Degree preferred
  • A minimum of one year experience in claims processing required, must include Professional and Institutional processing; previous experience in medical billing and coding required if no claims processing experience
  • Knowledge of ICD-10, CPT4, DRG, HCPCS codes, medical terminology, EDI and HIPAA protocols preferred
  • Knowledge of UB and HCFA 1500 forms
  • Certified Professional Coder (CPC) preferred
  • Experience with Word and Excel

Physical Requirements:

  • Prolonged periods of sitting at a desk and working on a computer
  • Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities
  • Must be able to drive a vehicle and daytime/overnight travel as required

Benefits:

  • 401K (4% Match, Immediate Vesting)
  • Accident insurance
  • Competitive salary
  • Critical Illness Insurance
  • Dental Insurance
  • Employee Assistance Program
  • Flexible Spending Account
  • Health & Wellness Program
  • Health Savings Account
  • Life & AD&D Insurance
  • Long Term Disability
  • Medical Insurance
  • Paid Time Off
  • Pet Insurance
  • Short Term Disability
  • Vision Insurance

Pre-Employment Screening: Drug Screen and Background Check Required

HealthOne is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status or any other status protected by state or federal law.

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