Insurance Claims Evaluator 1 pay range
Commonwealth of Pennsylvania · class code 04321
- Class code
- 04321
- Pay scale group
- ST 06
- Pay unit
- Year
- Bargaining unit
- A4
- State
- Pennsylvania
- The Commonwealth of Pennsylvania published pay range for Insurance Claims Evaluator 1 is $53,008 to $80,646 per year.
- Commonwealth of Pennsylvania Office of Administration keys this classification as class code 04321.
- This is the range the plan authorises, not the salary of any individual employee.
Class specification
The Commonwealth job specification for this class is published by Commonwealth of Pennsylvania Office of Administration. The passages below are quoted from it as published, not paraphrased, and cut to their opening sentences; the full specification is the authority on duties and qualifications. It was last revised 08/06/2015.
What the state says the job is
This is beginning level professional work in the evaluation and payment of special fund insurance claims. An employee in this job analyzes and evaluates insurance claim files and recommendations submitted by a contracted Third Party Administrator (TPA) for the payment of insurance claims. Work includes reviewing claims information submitted by the TPA to ensure compliance with statutory requirements and claims administration practices, and for appropriateness of recommendations; approving payment of claims and contractor invoices; identifying and researching claim issues and providing recommendations to the supervisor for resolution; and contacting claimants, TPA staff, attorneys, service providers, and other individuals to collect or provide information regarding the status of claims.
Examples of the work
• Reviews, audits, and approves contractor service invoices, provider payment authorizations, third party reviewer invoices, legal invoices, and third party settlements. • Reviews and approves Compromise and Release requests and Direction Request documents. • Reviews TPA requests for assistance and provides written recommendations regarding the handling of claims. • Assists in the preparation of reports and briefings. • Responds to questions from claimants, remediation consultants, providers, and attorneys regarding the status of benefits or payments.
Minimum qualifications
• One year of professional experience in the evaluation and payment of claims in multiple lines of insurance and a bachelor’s degree; or • An equivalent combination of experience and training.
Quoted from the Commonwealth job specification, read 2026-10-21.
Where this comes from
Commonwealth of Pennsylvania Office of Administration publishes this figure in Classification and Pay Plan (online, current annual salary ranges). Every number on this page is read from that document; nothing is estimated, modelled or averaged.
The Commonwealth also links this class code to its own job title and specification. That page is the official description of the classification; this page publishes its pay range.
The listed pay scale is available in the Commonwealth's current ST schedule.