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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.

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 ...

Welbehealth

Claims Examiner

CA · Remote

$55K - $73K/yr

In depth experience with Medicare and Medicaid claims processing * Demonstrated skills within Microsoft Office Applications & electronic claims processing systems * Strong organizational, analytical ...

Conduent, Inc.

Claims Processor

KY · Remote

$18/hr

Claims Processor (Remote) Are you detail-oriented with claims experience and looking for a remote opportunity where your performance is rewarded? We're hiring Claims Processors to join our team! Pay ...

Imagenet

Claims Examiner - Remote

Jacksonville, NC · Remote

$17 - $18/hr

We are looking for Experienced Claims Processor to join our rapidly growing team. Experience is ... Job Type: Full-time This is a fully remote position Pay: $17-18 per hour DOE Responsibilities:

ImageNetLLC

Claims Examiner - Remote

Tampa, FL · Remote

We are looking for Experienced Claims Processor to join our rapidly growing team. Experience is ... Job Type: Full-time This is a fully remote position Pay: $17-18 per hour DOE Responsibilities:

ImagenetLLC

Claims Examiner - Remote

Tampa, FL · Remote

$17 - $18/hr

We are looking for Experienced Claims Processor to join our rapidly growing team. Experience is ... Job Type: Full-time This is a fully remote position Pay: $17-18 per hour DOE Responsibilities:

WCC

Be Seen First

CFE/Special Investigator/Healthcare Auditor

Columbia, SC · Remote

... to Medicare/Medicaid claims. Essential Duties and Responsibilities Perform evaluation and ... processing system files (e.g., claims history, provider files) to determine provider billing ...

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

As of Jun 10, 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

State Medicaid Technical Business Analyst

Siritech Solutions Corp

Austin, TX • Remote

Full-time

Posted 7 days ago

Job description

Job Description:

The client is seeking an experienced Technical Business Analyst with strong Medicaid domain expertise to support large-scale state healthcare initiatives. The ideal candidate will work closely with business and technical stakeholders to gather requirements, analyze business processes, document system enhancements, support testing activities, and ensure successful delivery of Medicaid-related projects.

Key Responsibilities:

  • Conduct requirements gathering sessions with business users and Subject Matter Experts (SMEs).

  • Analyze business objectives, operational procedures, and system requirements.

  • Develop use cases, process flows, wireframes, acceptance criteria, and business documentation.

  • Analyze existing and proposed business processes and assess system impacts.

  • Assist in the development of project documentation in accordance with HHSC and DIR standards.

  • Serve as a liaison between business stakeholders and technical teams throughout the SDLC.

  • Participate in system testing activities, including test data preparation and test script execution.

  • Monitor project progress and provide status updates on enhancement activities and issue resolution.

  • Facilitate knowledge transfer through documentation, architecture reviews, and stakeholder communication.

  • Support implementation planning and recommend appropriate technical solutions.

Additional Responsibilities:

  • Assist with online help documentation and user support materials.

  • Participate in regular project status meetings.

  • Maintain project updates within ticketing and project management systems.

  • Deliver presentations and communications to both technical and non-technical audiences.

  • Collaborate with developers, DBAs, project managers, and business teams.

Required Skills:

  • Experience with Medicaid Claims Processing.

  • Experience analyzing business objectives and identifying alternative solutions.

  • Experience reviewing and evaluating user requirements and operational procedures.

  • Experience documenting user needs, program functions, and system requirements.

  • Experience performing cost/benefit analysis.

  • Experience documenting data input, output, and reporting requirements.

  • Experience with Azure DevOps and wireframe creation.

  • Strong analytical and problem-solving abilities.

  • Excellent verbal and written communication skills.

  • Strong stakeholder management and interpersonal skills.

  • Knowledge of software development lifecycle methodologies.

  • Knowledge of Agile and Scrum delivery methodologies.

  • Experience with Texas DIR Project Delivery Framework and associated templates.

  • Knowledge of information architecture and information management methodologies.

  • Understanding of enterprise architecture and infrastructure concepts.

  • Knowledge of emerging technologies and industry trends.

  • Understanding of data governance, integrity, and security best practices.

Preferred Skills:

  • Texas Health and Human Services (HHSC) project experience.

  • State Medicaid system modernization experience.

  • Healthcare payer or claims processing platform experience.

  • Experience supporting large government technology initiatives.

  • Advanced process modeling and workflow documentation expertise.

Qualifications:

  • Minimum 12+ years of Business Analysis experience.

  • Strong Medicaid Claims Processing experience required.

  • Experience working with Texas State Agencies preferred.

  • Experience working in Agile/Scrum environments.

  • Ability to communicate effectively with both technical and non-technical stakeholders.

Education:

  • Bachelor\'s degree in Computer Science, Information Systems, Business Administration, Healthcare Informatics, or related field preferred.

Certifications:

  • CBAP (Preferred)

  • PMI-PBA (Preferred)

  • Certified Scrum Master (Preferred)

  • Agile Business Analyst Certification (Preferred)

Additional Notes:

  • Local Austin, Texas candidates only (within 50-mile radius).

  • Candidates relocating from outside Texas will not be considered.

  • Interview Process: Microsoft Teams.

  • Medicaid Claims Processing experience is mandatory.