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Insurance Claims Representative Jobs (NOW HIRING)

AppleOne

Remote Med Insurance Claims Rep

Bakersfield, CA · Remote

$23/hr

Job Summary We are seeking a Remote Med Insurance Claims Rep for California Residents this is a busy managed care healthcare environment. This role is ideal for a detail-oriented medical claims ...

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Insurance Claims Representative information

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How much do insurance claims representative jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for insurance claims representative in the United States is $24.56, according to ZipRecruiter salary data. Most workers in this role earn between $17.79 and $28.85 per hour, depending on experience, location, and employer.

What is an insurance claims representative?

An insurance claims representative is a professional who investigates and evaluates insurance claims to determine coverage and settlement amounts. They review policy details, gather evidence, and communicate with claimants, often using claims management software, to ensure accurate and fair claim processing.

What does an Insurance Claims Representative do?

An Insurance Claims Representative is responsible for evaluating insurance claims submitted by policyholders. They investigate the details of each claim, determine the extent of the insurance company's liability, and help ensure that claims are processed accurately and efficiently. They may gather information from claimants, witnesses, and other parties, review documentation, and communicate decisions to customers. Their goal is to provide fair settlements while adhering to company policies and legal guidelines.

What are the key skills and qualifications needed to thrive as an Insurance Claims Representative, and why are they important?

To thrive as an Insurance Claims Representative, you need a solid understanding of insurance policies, claims processes, and investigative techniques, typically supported by a high school diploma or associate degree. Familiarity with claims management software, CRM systems, and occasionally industry certifications such as AIC (Associate in Claims) are commonly required. Strong customer service, analytical thinking, and effective communication skills help you manage claims efficiently and support clients during stressful situations. These abilities are vital for ensuring accurate claims resolution, maintaining customer satisfaction, and upholding the company's reputation.

What claims adjuster makes the most money?

Senior claims adjusters, especially those specializing in complex or high-value claims such as commercial or large-loss claims, tend to earn the highest salaries in the field. Adjusters with extensive experience, specialized certifications, and strong negotiation skills typically command higher pay. Geographic location and employer size can also influence earnings for claims adjusters.

What Does an Insurance Claims Representative Do?

An insurance claims representative assesses customer insurance claims. Your duties in this career include visiting accident sites and interviewing witnesses or customers to determine the scope of the claim. You also determine whether or not it is worth negotiating a settlement, and if so, you ensure all settlement claims are handled quickly. In addition to assessing accidents and claims, you update customer policies depending on their history. Qualifications for the career include experience and job skills. You should have excellent customer service, a firm knowledge of all company policies, and computer literacy.

How to get a job as a claims adjuster with no experience?

To become a claims adjuster with no experience, focus on obtaining relevant certifications such as the Property and Casualty (P&C) license and develop strong communication and analytical skills. Entry-level positions often require a high school diploma or equivalent, and some companies offer training programs for new hires to gain industry knowledge on the job.

What are some common challenges Insurance Claims Representatives face when handling complex claims?

Insurance Claims Representatives often encounter challenges such as managing high caseloads, interpreting intricate policy details, and handling sensitive conversations with policyholders during stressful situations. They must balance empathy with adherence to company policies and regulations, all while investigating and verifying the validity of claims. Effective communication, time management, and problem-solving skills are essential to navigate these complexities and deliver fair outcomes for both the client and the insurer.

Is claim adjusting a dying field?

Claim adjusting is a stable profession within insurance, requiring strong analytical skills and knowledge of insurance policies. While automation and digital tools are changing some processes, human adjusters remain essential for complex claims and customer interactions, ensuring the field continues to offer employment opportunities.

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

AspectInsurance Claims RepresentativeInsurance Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require licensingLicensing often required; certifications like AIC or CPCU beneficial
Work EnvironmentOffice settings, customer service interactions, claims processingFieldwork, site inspections, or office-based assessments
Employer & Industry UsageInsurance companies, claims departmentsInsurance companies, independent adjusting firms
Common Search & ComparisonOften compared for claims handling rolesMore focused on damage assessment and investigation

The main difference between an Insurance Claims Representative and an Insurance Adjuster lies in their roles. Claims Representatives primarily handle customer interactions and process claims within an office environment, while Adjusters often conduct field inspections and assess damages. Both roles require relevant licensing and are integral to the insurance industry, but they focus on different aspects of claims management.

More about Insurance Claims Representative jobs
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Insurance Claims Representative jobs near you
Infographic showing various Insurance Claims Representative job openings in the United States as of July 2026, with employment types broken down into 91% Full Time, 7% Part Time, and 2% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $51,091 per year, or $24.6 per hour.
Insurance Claims Representative

Insurance Claims Representative

Blackstone Medical Services

Tampa, FL

Full-time

Posted 9 days ago

Job description

Here we Grow Again! Join us for another record breaking year!

We are seeking Insurance Claims Representatives.

Duties include:

  • Following up on outstanding insurance claims.
  • Appealing denials and working with the insurance company to get claims paid.
  • Working accounts receivable to get any unpaid balances paid up.
  • Coordinating with the finance area to make the benefit verification more accurate and efficient.
  • Receive and post payments to patient accounts daily.
  • Performing necessary follow-up to ensure timely resolution of appeals, re-billing's, obtaining updated insurance information.
  • Apply knowledge of third party payer guidelines in reviewing denied claims
  • Correct insurance information on rejected insurance claims and resubmit for processing

Candidate should be:

  • Familiar with and able to utilize various Electronic Claims software
  • Performs duties related to departmental collections including follow-up on outstanding accounts.
  • Follow up on all outstanding accounts via telephone or portal
  • Willing to help others

About Blackstone Medical Services:
The largest Home Sleep Testing company in the country!
Blackstone Medical Services is a rapidly growing diagnostic technology company looking for team members who enjoy working in a productive environment while helping patients improve the quality of their health.
Blackstone Medical provides a new sleep medicine technology (In-Home Diagnostic Sleep Testing) which is growing in demand as awareness increases among healthcare providers and patients.
www.blackstonemedicalservices.com
Company address: 550 N Reo Street, Suite 250, Tampa FL 33609

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