Claims Processor Jobs in the United States

Crystal Stairs

Los Angeles, CA

The Claims Processor will provide excellent client service by accurately processing provider claims in a timely manner while adhering to the contractual requirements of the California Department of Education and LA County Department of Public Social Services as well as Crystal Stairs, Inc. policies and procedures. An AA/AS Degree in Accounting, Business, or Human Services preferred/or a minimum of two years of verifiable college coursework with a focus on accounting or business; verifiable work experience may be substituted for college level education.

SDVInternational

Austin, TX

We are recruiting multiple Medical Claims Processor Leads to manage a program for a premier health care solutions provider out of Austin, Texas to support the U.S. Department of Veteran’s Affairs! International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision Clinical Modification (ICD-10-CM) experience.

Brio Living Services

$20

Grand Rapids, Michigan

In this position, you’ll analyze, support, and execute key functions within the claims adjudication process for our Shore-to-Shore PACE programs, including LifeCircles PACE, Huron Valley PACE, and Thome PACE. Your work directly supports the financial integrity of our programs and helps keep care moving forward for the older adults we serve.

Abacus Service Corporation

MASON, OH

Drive client satisfaction - Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include EyeMed Account Managers, Operations, Information Systems, Client Representatives and EyeMed leadership team. Start Time: 12:00 AM Hours: 8:00am to 5:00pm Location: CINCINNATI SERVICE CENTER 4000 LUXOTTICA PL MASON OH 45040 Education: Additional Job Details: ACTUAL JOB TITLE: Claims Coordinator.

Alura Workforce Solutions

Rancho Cucamonga, CA

REQUIREMENTSTwo (2) years of experience as a Data Entry Processor Data Entry Processor experience preferably in an HMO or Managed Care setting. This includes validating member coverage, clearing system edits and categorizing a claim type to ensure the claim routes to the appropriate workgroup for adjudication.

Pennymac

$39000 - $55000

Moorpark, California

PENNYMAC: Pennymac (NYSE: PFSI) is a specialty financial services firm with a comprehensive mortgage platform and integrated business focused on the production and servicing of U.S. mortgage loans and the management of investments related to the U.S. mortgage market. Pennymac is committed to conducting a business that makes positive contributions and promotes long-term sustainable growth and to fostering an equitable and inclusive environment, where all employees and customers feel valued, respected and supported.

MUSC

null, South Carolina

Account maintenance: Updating registration, authorization issues, identifying charge correction, , processing adjustments as needed and denial follow up according to payer rules and departmental policies. Uses payer websites to stay current on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends.

PHA Health

McCook, NE

PHA Health provides health plans that are affordable, sustainable, and promote well-being by empowering employers and employees to be financially, emotionally, and physically healthy. PHA Health, powered by Wilcox Financial Services is a leading insurance brokerage that specializes in offering group employee health benefits.

Broadway Ventures

Atlanta, GA

As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions.

Ava Consulting

Mason, OH

Drive client satisfaction - Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include client Account Managers, Operations, Information Systems, Client Representatives and client leadership team. Has a working knowledge of interface systems that include the client claims system, Metastorm, Exclaim and EyeNet.

CareGard Warranty Services, Inc.

Grapevine, TX

Verify claim eligibility by analyzing contracts, loan documents, payoff statements, insurance settlements, total loss documentation, and various other documents required. The Processor I, GAP Claims is responsible for reviewing, processing, and adjudicating Guaranteed Asset Protection (GAP) claims in accordance with company guidelines, policy provisions, lender requirements, and applicable state and federal regulations.

NR Consulting LLC

$30 - $32.34

New Haven, CT

Determines death claim benefits based on terms of policy and date of death; calculates payments, including dividends, premiums, loans and date of birth adjustments on death claim proceeds; processes any online accounting in order to adjust the claim values to the date of death; transfers proceeds to appropriate account for reduction of an outstanding loan on other policies or payment of initial premium on new applications; processes funeral assignments and payments to funding companies. May split policy depending on wishes of claimants, converting to new or transferring to other existing policies; sets up settlement options and deferred payment streams; coordinates with New Business as necessary for new applications and policy numbers.

Moda Health

$19.43 - $21.86

Milwaukie, OR

Review, analyze, price, and resolve inpatient claims through the utilization of available resources for moderate to complex inpatient claims, adjustments, and file reviews. Works internally with Healthcare Services, Membership Accounting, Customer Service, Hospital Auditors, Provider Correspondence, and Professional Relations.

Moda Health

$17.34 - $18.36

MILWAUKIE, OR

For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees.

FedPoint

$19 - $23

PORTSMOUTH, NH

To learn more, visit[fedpointusa.com](https://gcc02.safelinks.protection.outlook.com/?url=http://www.fedpointusa.com/anddata=05%7C02%7Cjallen@fedpointusa.com%7C6b669038e7b54b65fcfc08dd5843eeee%7C76b7e3e72ebf49a7bb26500f7a43628a%7C0%7C0%7C638763770986609448%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ==%7C0%7C%7C%7Candsdata=zdtQJryXoRWgwP7ZtAs9ahn4sWP2xs0nFkMFL789Wkw=andreserved=0){target="_blank"}. - Comprehensive*wellness program*offering a variety of resources and activities to help support your well-being in the following areas: career, financial, mental, emotional, physical, social and community.

Diverse Linx

Tampa Bay, FL

Customer and Internal Business Partner Interaction - Communicate with member, healthcare providers and internal business partners to resolve the claim or gather required additional information. This role involves gathering information, evaluating claims for validity, and ensuring that all necessary documentation is complete.

Comfort Dental East Mesa

Mesa, AZ

Primary Duties Include: • Preparing and electronically submitting dental insurance claims promptly and accurately, including pre-authorizations, narratives, and supporting documentation. • Monitoring outstanding claims, generating aging reports, following up with insurance carriers on delays/denials, and pursuing appeals to recover maximum reimbursements.

Advantage Tech

Kansas City, MO

Collaborate on Data Integration Processes - Work with ETL teams (primarily Informatica, occasionally SSIS) to support data movement and transformation between systems, ensuring accuracy and consistency. Testing and Quality Assurance - Validate SQL code and database changes through unit testing and assist with integration testing to ensure reliability and compliance with requirements.

Belcan

MASON, OH

Job Title: Claims Processor Location: MASON, OH Zip Code: 45040 Duration: 1+ months Pay Rate: $17.86/hr. Your application and candidacy will not be considered based on race, colour, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws.

Pennymac

$38000 - $53000

Fort Worth, Texas

As the Claims Coordinator, your responsibilities will include managing transfer of files from the Presale Team, triaging files to verify completion of critical steps from the Presale Team, and assigning pending tasks to the Claims Processor ensuring workload balance on the team. PENNYMAC: Pennymac (NYSE: PFSI) is a specialty financial services firm with a comprehensive mortgage platform and integrated business focused on the production and servicing of U.S. mortgage loans and the management of investments related to the U.S. mortgage market.

Consonus Pharmacy

Portland, Oregon

As the Claims Adjudication Specialist, your responsibilities will include preparing accurate invoices, collecting and processing payments on claims, reconciling accounts, maintaining knowledge of current policies & procedures, verifying services are authorized and appropriate, and assisting customers with inquires via telephone. Consonus Pharmacy is a closed-door long-term care pharmacy specializing in the needs of nursing facilities, assisted living residents, and their caregivers.

Pinnacle Environmental Management Support

$18

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POSITION SUMMARY: This position provides paraprofessional work, which involves assisting clients in participation in state-administered Underground Storage Tank (UST) cleanup trust funds. Keywords: claims, analysis, excel, management, insurance, UST, remediation, petroleum, environmental, financial, accounting, underground storage tanks.

Lorven Technologies

Not available, WA

The Business Analyst will also work with cross-functional teams, including IT, operations, and compliance, to implement solutions that enhance the efficiency and accuracy of payment and claims systems. The role involves working closely with business stakeholders to gather requirements, document workflows, and identify opportunities for process improvements.

MMC Group

$20 - $22

East Hartford, CT

Throughout the past 30 years plus, MMC, one of the most trusted names in workforce management services, has successfully delivered strategic solutions to large and small businesses in numerous industries. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

Lyric National

Lincolnwood, IL

This role conducts detailed reviews of medical documentation, benefits coverage, and contractual terms to determine liability and negotiate equitable resolutions while maintaining regulatory compliance and protecting plan integrity. Lyric National We provide skilled nursing facilities and other long-term care facilities with a concierge platform for in-facility healthcare services funded through a supplemental accident and sickness policy (Enhanced Plan).

Veterans Sourcing Group

Albuquerque, NM

Job Description:A Medical Claims Processor is responsible for reviewing and processing healthcare insurance claims to ensure accuracy, completeness, and compliance with policy terms. Daily duties:Reviewing medical claim submissions and verifying the information is entered correct in our system.

Moda Health

$20.88 - $23.49

Milwaukie, OR

Performs COB updates (excluding Commercial), file reviews, issues adjustment related letters to members and providers, performs payment offsets and also validates and completes stop payment requests. Assists in customer service inquiries regarding contractual and administrative policies and applies excellent customer service when a phone call is needed to complete an adjustment or other support work.

Moda Health

$65682.16 - $82107.97

Portland, OR

Ensure the timely and accurate response to written correspondence or phone calls on a wide variety of subjects including medical necessity for durable medical equipment appeals, subrogation, APC claims, vendor edits, and rental network pricing etc. Strong analytical, problem solving, and decision-making skills with demonstrated ability to handle and resolve complaints, correct errors and resolve departmental issues in accordance with Moda Health contracts and Moda Health Inc. policies.

Kinetic Personnel Group, Inc.

$20 - $21

Redlands, CA

The ideal candidate is highly organized, deadline-driven, and comfortable communicating with physicians and cross-functional teams to maintain efficient report workflow. This role is responsible for ensuring transcription accuracy, verifying data integrity, and confirming completeness of documentation prior to final submission.

Colorado School of M

$56500 - $64000

Golden, CO

The position plays a key role in fostering an environment focused on process efficiency and effectiveness, helping to reduce the financial and administrative burdens on campus constituents and requires a proactive approach to maintaining system integrity, improving processes, and delivering exceptional service to the campus community. Payroll Processor and Accountant Colorado School of Mines Salary: $56,500.00 - $64,000.00 Annually Job Type: Full Time Job Number: GLA-JR106472-5/25 Location: Golden, CO Department Information Engineering a world of possibilities We are seeking a skilled and detail-oriented Payroll Accountant to join our team.

Paychex

Winter Haven, FL

Prepares crop insurance documents, including applications, worksheets, acreage and production reports, plant inventories, and farming reports, using information provided by agents and growers. The selected candidate must be eligible to obtain (or already have) a Florida Resident Customer Representative (4-40) license or a Crop-Hail and Multiple Peril Crop Insurance Agent (4-30) license.

MUSC

Charleston, South Carolina

Ability to bend at the waist, kneel, climb stairs, reach in all directions, fully use both hands and legs, possess good finger dexterity, perform repetitive motions with hands/wrists/elbows and shoulders, reach in all directions. Prior account analysis, credit resolution, billing and/or insurance follow up experience in a hospital or physician office setting preferred with working knowledge of insurance payor remittances, and Epic system knowledge helpful.

Veterans Sourcing Group

Helena, MT

Enter data entry correctly, efficiently and completed within a strict timeline. Functional Knowledge:Has developed skills in a range of processes, procedures, and systems.

Veterans Sourcing Group

Helena, MT

Performs business support or technical work, using data organizing and coordination skills. Impacts a team, by example, through the quality service and information provided.

Veterans Sourcing Group

Lexington, KY

These individuals play a key role in ensuring accurate processing, proper document handling, and a smooth experience for our members. Ability to learn quickly, follow established procedures, and maintain focus in a high-volume workflow.

Cross Key Management

Newtown, PA

Overview: The Title Processor plays a key role in ensuring real estate transactions move smoothly by verifying, clearing, and preparing all necessary title-related documentation. This role is responsible for identifying and resolving title issues, coordinating with buyers, sellers, agents, attorneys, and lenders, and ensuring that all documents meet legal and lender requirements.

Cross Key Management

Bethlehem, PA

Overview: The Title Processor plays a key role in ensuring real estate transactions move smoothly by verifying, clearing, and preparing all necessary title-related documentation. This role is responsible for identifying and resolving title issues, coordinating with buyers, sellers, agents, attorneys, and lenders, and ensuring that all documents meet legal and lender requirements.

U.S. Bank

$20 - $24.09

Saint Paul, MN

May involve analytical research, four wall investigations, validations, general transaction processing, issuing provisional/final credit, reversing fees and interest, sending customer facing communications, and/or recovering funds through merchants and other financial institutions. In addition, certain positions may also be subject to the requirements of FINRA, NMLS registration, Reg Z, Reg G, OFAC, the NFA, the FCPA, the Bank Secrecy Act, the SAFE Act, and/or federal guidelines applicable to an agreement, such as those related to ethics, safety, or operational procedures.

BancFirst Insurance Services

$42000 - $48000

Tulsa, OK

We are an Oklahoma-based, independent insurance agency with multiple branch locations that are uniquely positioned to provide all the benefits of a large corporation while maintaining a small company atmosphere and relaxed work environment. Our mission is to provide the best risk management service to our customers by attracting and retaining the very best talent in the industry.

Village Capital & Investment

Henderson, NV

This role is responsible for managing bankruptcy-related loan accounts, ensuring regulatory compliance, and coordinating with internal teams, borrowers, attorneys, and trustees. The ideal candidate has strong organizational skills, a solid understanding of mortgage servicing regulations, and the ability to work independently in a fast-paced environment.

Pacific Air Forces

Hickam AFB, HI

Drives primarily within the confines of a military installation or under other limited driving conditions (low speeds, regular predetermined routes, etc.) Responsibilities Drives a variety of vehicles, some of which have a GVW of more than 32,000 pounds (this includes K-Loaders, step/stair trucks, passenger buses, 250 gallon water trucks, three/nine ton Hi-lift truck and various conveyors). 3. Ability to judge road/traffic conditions and read installation maps to determine the shortest and safest route, and meet pickup and delivery deadlines and schedules, while operating motor vehicles; and to judge aisles, doorways, loads and load balance, and operate controls to maneuver fork lift trucks.

Molina Healthcare

$21.65 - $31.71

Spokane, WA

Ability to work cross-collaboratively across a highly matrixed organization and establish and maintain effective relationships with internal and external stakeholders. + Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.

Crystal Stairs

Los Angeles, CA

We are seeking a Provider Payments Assistant, that will process and print provider payments exported from Stage 1 and CCAP databases, complete research necessary to define and resolve problems as they relate to processing of provider payments, and update fiscal stale dated check spreadsheets for Stage 1 and CCAP bank accounts. This position assists with processing, printing, mailing and answering provider inquiries for MISC 1099's forms for Stage 1 and CCAP providers.

Access To Healthcare Network

Las Vegas, NV

This role ensures high-quality service to Ryan White clients through leadership, workflow oversight, training, and accurate insurance eligibility and enrollment support. Minimum one year in healthcare-related social work OR two years working with special needs populations with case management knowledge.

Advertising Checking Bureau

Memphis, TN

The Account Specialist monitors work assignments delegated to (Customer Service Representatives, Shippers, Data Entry Clerks, and Claims Processors and assists with special projects and the preparation of reports (routine and/or ad hoc). The Account Specialist may be required to assist with and/or perform all work assignments delegated to other hourly employees (Customer Service Representatives, Shippers, Data Entry Clerks, and Claims Processors).

Advertising Checking Bureau

Memphis, TN

The Team Lead is responsible for providing outstanding customer service to clients by assisting the Supervisor and/or Key Personnel in executing, delegating, and following up on work assignments. The Team Lead monitors work assigned to Customer Service Representatives and Claims Processors, and assists with special projects and the preparation of routine and ad hoc reports.

Divergent Talent

$55 - $65

St. Louis, MO

The Senior Product Manager – Payment Integrity will lead the strategy, roadmap, and execution for products and capabilities that ensure accurate, compliant, and cost-efficient payments across the organization. Define and own the end-to-end product vision and multi-year roadmap for Payment Integrity products (pre-payment, post-payment, claims analytics, audit workflows, rules engines, etc.).

Mercalis

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Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. o Manage the process for timely review & approval payment batches for the release of funds for payment of approved patient claims via multiple payment solutions providers (e.g., medical claims payments, virtual & physical debit card payments, checks paid to patients, and other electronic forms of direct payment to health care providers).

ProTrain

Rancho Santa Margarita, CA

We provide a CE-Turnkey Solution and partnership opportunities for institutions of higher learning to provide programs to various verticals such as Military Tuition Assistance (TA), Military Spouses (MyCAA), Wounded Warriors, Veterans, Unemployed (WIA), Corporate and Individuals. ProTrain is an affordable solution for students seeking to prepare for an in-demand career that will help move them and America forward to achieve the goal of Education 2 Employment!

AmeriHealth Caritas

Raleigh, NC

The director is the main point of contact and develops partnerships with other departments including Implementations, Sales, Account Management, Informatics, Customer Service, and corporate accounting regarding membership. The Director, Finance is responsible for the oversight of all financial activities for the plan including but not limited to financial statements, audit activities, active participation in the annual budget process and reconciliation of operational staff.