How To Become A Claim Processing Specialist: What It Is and Career Path

What is a claim processing specialist and how to become one

Updated January 8, 2025

3 min read

There is more than meets the eye when it comes to being a claim processing specialist. For example, did you know that they make an average of $16.56 an hour? That's $34,436 a year! Between 2018 and 2028, the career is expected to grow -4% and produce -105,300 job opportunities across the U.S.

ScoreClaim Processing SpecialistUS Average

Salary

2.7

Avg. Salary $34,436

Avg. Salary $59,228

Stability Level

5.9

Growth Rate -4%

Growth Rate 0.3%

Diversity

9.3

Race

American Indian and Alaska Native 0.63%

Asian 7.46%

Black or African American 11.47%

Hispanic or Latino 17.57%

Unknown 5.01%

White 57.85%

Gender

female 79.70%

male 20.30%

Age - 39

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 - 39

Stress Level

5.9

Stress level is manageable

7.1 - high

Complexity Level

6.6

Complexity Level is challenging

7 - challenging

Work Life Balance

6.5

Work Life balance is good

6.4 - fair

Key steps to become a claim processing specialist

Explore claim processing specialist education requirements

Most common claim processing specialist degrees

Bachelor's

39.8 %

Associate

25.9 %

High School Diploma

19.1 %

Start to develop specific claim processing specialist skills

Skills	Percentages
Data Entry	12.19%
Process Claims	10.11%
Insurance Claims	6.55%
Inbound Calls	6.05%
CPT	5.28%

Complete relevant claim processing specialist training and internships

Accountants spend an average of 6-12 months on post-employment, on-the-job training. New claim processing specialists 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 processing specialist based on U.S. Bureau of Labor Statistics data and data from real claim processing specialist resumes.

Research claim processing specialist duties and responsibilities

Manage expedition of appeals via problem solving and collaboration with other departments.
Provide consumer-oriented health benefit plans, process all types of health claims knowledgeable of ICD-9 and CPT codes.
Process medical claims for Medicaid recipients via a state-fund Medicaid insurance carrier per plan guidelines and department procedures.
Ensure all work processes are compliant with various HIPAA regulations.

Prepare your claim processing specialist resume

When your background is strong enough, you can start writing your claim processing specialist 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 processing specialist 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 Processing Specialist Resume templates

Build a professional Claim Processing Specialist 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 Processing Specialist resume.