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Medicaid Claims Processing Remote Jobs (NOW HIRING)

Memorial Health

Medicaid Specialist

Springfield, IL · Remote

$18.34 - $28.42/hr

Prioritizes claims based on specified criteria and electronically files the claim, ensuring careful adherence to Medicaid guidelines, timeliness, accuracy, and processing procedures. At prescribed ...

Memorial Health

Medicaid Specialist

Springfield, IL · Remote

$18.34 - $28.42/hr

Prioritizes claims based on specified criteria and electronically files the claim, ensuring careful adherence to Medicaid guidelines, timeliness, accuracy, and processing procedures. At prescribed ...

Conduent, Inc.

Medicaid Claims Data Entry Associate

MT · Remote

$17/hr

This is a great opportunity to learn about Medicaid Provider support and the medical eligibility and claims process! About the Role Location - REMOTE US Only $16-$17 per hour based on experience ...

Conduent, Inc.

Remote Claims Processing Clerk

KY · Remote

$15/hr

Remote Claims Processing Clerk Schedule: Monday- Friday 8:00 AM - clean desk (based on business needs) Training Schedule: 4-week paid training Pay Rate: $15.00 per hour- please note this rate may be ...

NTT DATA

Medical Claims Processor - Remote

$17.50 - $22/hr

Remote Claims Processing Associate At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our ...

InterSources

Medicaid Subject Matter Expert

Remote, USA Duration: Long Term Contract Required Qualifications: * More than four (4) years of ... CMS Federal Reporting, quality measures, claims processing, Medicaid program eligibility, provider ...

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Medicaid Claims Processing Remote information

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How much do medicaid claims processing remote jobs pay per hour?

As of Jul 2, 2026, the average hourly pay for medicaid claims processing remote in the United States is $19.16, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.67 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Medicaid Claims Processing Remote professional, and why are they important?

To thrive in a Medicaid Claims Processing Remote role, you need a solid understanding of medical billing, coding, and Medicaid regulations, typically supported by experience in healthcare administration or claims processing. Familiarity with claims management software, medical coding systems (such as ICD-10 or CPT), and electronic data interchange (EDI) platforms is essential. Strong attention to detail, organizational skills, and effective communication are crucial soft skills for accuracy and collaboration. These skills ensure timely and accurate processing of claims, compliance with regulations, and effective resolution of claim issues in a remote environment.

What is Medicaid Claims Processing Remote?

Medicaid Claims Processing Remote refers to the job of reviewing, analyzing, and processing Medicaid insurance claims from a location outside of a traditional office, often from home. Professionals in this role ensure that claims are accurate, complete, and comply with Medicaid regulations before approving or denying payment. Remote workers use specialized software to access claim information securely and may communicate with healthcare providers and patients to gather additional details. This job requires attention to detail, knowledge of Medicaid policies, and the ability to work independently. Remote claims processors play a crucial role in ensuring the timely and accurate reimbursement of healthcare services for Medicaid recipients.

What are some common challenges faced in a remote Medicaid Claims Processing position, and how can they be managed?

Working remotely as a Medicaid Claims Processor can present challenges such as staying up-to-date with changing regulations, maintaining attention to detail when reviewing large volumes of claims, and ensuring secure handling of sensitive patient data. To manage these challenges, it's important to regularly participate in team training sessions, utilize checklists or claim management software to minimize errors, and follow strict data security protocols. Open communication with supervisors and colleagues through virtual platforms also helps in resolving complex claims and staying connected with team goals.
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Medicaid Claims Processing Remote jobs near you

Senior Data Analyst - Medicaid Exp Must - W2

CLOUDSCOUTS SOFTWARE SOLUTIONS LLC

Frisco, TX • Remote

$79K - $100K/yr

Full-time

Posted 8 days ago

Job description

Job Title: Senior Data Analyst Medicaid Exp Must
Experience : 10+ Years
Key Responsibilities:
Analyze large volumes of Medicaid healthcare data, including claims, enrollment, provider, eligibility, encounter, and pharmacy data.
Gather, analyze, and document business and data requirements from Medicaid business stakeholders.
Develop and maintain complex SQL queries, stored procedures, and data validation scripts for data extraction and analysis.
Perform detailed analysis of Medicaid claims adjudication, member eligibility, provider networks, and reimbursement processes.
Design, develop, and maintain dashboards, scorecards, and reports using BI tools such as Tableau, Power BI, or Cognos.
Conduct data profiling, data quality assessments, and root cause analysis to ensure accuracy and completeness of Medicaid data.
Collaborate with business teams to support Medicaid regulatory reporting, including CMS, state-specific mandates, and quality measures.
Analyze healthcare KPIs, utilization trends, cost containment opportunities, and operational metrics.
Support Medicaid programs such as Managed Care, Fee-for-Service (FFS), Dual Eligible, LTSS, and Value-Based Care initiatives.
Work closely with ETL and data engineering teams to validate source-to-target mappings and data transformations.
Perform impact analysis for system enhancements, regulatory changes, and Medicaid policy updates.
Create functional specifications, business requirement documents (BRDs), and data mapping documents.
Participate in Agile ceremonies including sprint planning, backlog grooming, daily stand-ups, and retrospectives.
Ensure compliance with HIPAA regulations and healthcare data security standards.
Provide mentorship and guidance to junior analysts and team members.
Required Skills:
Healthcare/Medicaid Domain:
Strong experience in Medicaid programs and healthcare payer systems.
Deep understanding of Medicaid claims processing lifecycle.
Experience with:
Member Eligibility and Enrollment
Claims Adjudication
Provider Management
Encounters and Capitation
Prior Authorization
Care Management
Pharmacy and PBM data
ICD-10, CPT, HCPCS, DRG, NDC coding systems
CMS and State Medicaid reporting

This is a remote position.