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What is a claim processor and how to become one

Updated January 8, 2025
3 min read
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Typically, claim processors work in the insurance industry. So while you won't have a ton of leeway when it comes to picking a job, you'll at least have some structure to your job.

Claim processors work with insurance claims. One claim after another. A lot of their days consist of analyzing insurance information and data entry. Other times, claim processors issue reimbursements for insurance claims.

The hardest part of your job might be deciding whether a claim should be accepted or denied. It's not easy turning people away so you might want to grow some "thick skin" before going into this career. As much as you may want to, not every claim can be accepted.

ScoreClaim ProcessorUS Average
Salary
3.2

Avg. Salary $41,201

Avg. Salary $59,228

Stability Level
9.3

Growth Rate -6%

Growth Rate 0.3%

Diversity
4.6
Race

American Indian and Alaska Native 0.50%

Asian 5.19%

Black or African American 11.20%

Hispanic or Latino 16.69%

Unknown 4.40%

White 62.03%

Gender

female 77.13%

male 22.87%

Age - 43
Race

American Indian and Alaska Native 3.00%

Asian 7.00%

Black or African American 14.00%

Hispanic or Latino 19.00%

White 57.00%

Gender

female 47.00%

male 53.00%

Age - 43
Stress Level
9.3

Stress level is very high

7.1 - high

Complexity Level
9.6

Complexity Level is advanced

7 - challenging

Work Life Balance
3.7

Work Life balance is poor

6.4 - fair

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Claim Processor career paths

Key steps to become a claim processor

  1. Explore claim processor education requirements

    Most common claim processor degrees

    Bachelor's

    43.0 %

    Associate

    23.4 %

    High School Diploma

    16.5 %
  2. Start to develop specific claim processor skills

    SkillsPercentages
    Customer Service19.54%
    Data Entry8.06%
    Medical Terminology5.33%
    CPT5.12%
    Claims Processing4.26%
  3. Complete relevant claim processor training and internships

    Accountants spend an average of 1-2 years on post-employment, on-the-job training. New claim processors learn the skills and techniques required for their job and employer during this time. The chart below shows how long it takes to gain competency as a claim processor based on U.S. Bureau of Labor Statistics data and data from real claim processor resumes.
  4. Gain additional claim processor certifications

    Claim processor certifications can show employers you have a baseline of knowledge expected for the position. Certifications can also make you a more competitive candidate. Even if employers don't require a specific claim processor certification, having one may help you stand out relative to other applicants.

    The most common certifications for claim processors include Certified Billing and Coding Specialist (CBCS) and Certified Medical Office Manager (CMOM).

    More About Certifications
  5. Research claim processor duties and responsibilities

    • Experience in many facets of the managed healthcare insurance business.
    • Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
    • Use ICD-9, CPT-4 and other medical manuals to adjudicate claims.
    • Analyze claims submit by providers and facilities for appropriate ICD-9, CPT and HCPCS codes against charges that are being bill.
  6. Prepare your claim processor resume

    When your background is strong enough, you can start writing your claim processor resume.

    You can use Zippia's AI resume builder to make the resume writing process easier while also making sure that you include key information that hiring managers expect to see on a claim processor resume. You'll find resume tips and examples of skills, responsibilities, and summaries, all provided by Zippi, your career sidekick.

    Choose From 10+ Customizable Claim Processor Resume templates

    Build a professional Claim Processor resume in minutes. Browse through our resume examples to identify the best way to word your resume. Then choose from 10+ resume templates to create your Claim Processor resume.
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  7. Apply for claim processor jobs

    Now it's time to start searching for a claim processor job. Consider the tips below for a successful job search:

    1. Browse job boards for relevant postings
    2. Consult your professional network
    3. Reach out to companies you're interested in working for directly
    4. Watch out for job scams

How Did You Land Your First Claim Processor Job

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Average claim processor salary

The average Claim Processor salary in the United States is $41,201 per year or $20 per hour. Claim processor salaries range between $26,000 and $62,000 per year.

Average Claim Processor Salary
$41,201 Yearly
$19.81 hourly

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Claim Processor reviews

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A zippia user wrote a review on May 2019
Cons

That I know I make more money working in many other fields.


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Updated January 8, 2025

Zippia Research Team
Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

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