ZipRecruiter

Log In

2

Medicaid Claims Processing Remote Jobs in Raleigh, NC

VIVA USA INC

Technical Writer

Raleigh, NC · On-site +1

... Medicaid Advance Planning Documents and other federal funding processes Required 3 Years Notes: Remote VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for ...

Astyra Corporation

Contracts Writer

Raleigh, NC · Remote

$35 - $37/hr

This is a remote position. *Local to the Raleigh, NC area only, please. Description: * This ... Medicaid Advance Planning Documents and other federal funding processes, Required 3 Years Proper ...

UNC HEALTH

Revenue Cycle Representative

Chapel Hill, NC · On-site +1

$18.12 - $25.51/hr

Process paper correspondence as assigned. Performs all duties in a manner which promotes teamwork ... Edit claims (DNB, Coverage Changes, Claim Edits, Stop Bills) within scope of authority (or escalate ...

UNC HEALTH

Revenue Cycle Representative

Chapel Hill, NC · On-site +1

$18.12 - $25.51/hr

Process paper correspondence as assigned. Performs all duties in a manner which promotes teamwork ... Edit claims (DNB, Coverage Changes, Claim Edits, Stop Bills) within scope of authority (or escalate ...

previous page

Showing results 41-60

All JobsMedicaid Claims Processing JobsMedicaid Claims Processing Remote JobsMedicaid Claims Processing Remote Jobs in Raleigh, NC

Medicaid Claims Processing Remote information

See Raleigh, NC salary details

$11

$18

$25

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

As of Aug 8, 2026, the average hourly pay for medicaid claims processing remote in Raleigh, NC is $18.63, according to ZipRecruiter salary data. Most workers in this role earn between $15.87 and $20.10 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?

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.
What are the most commonly searched types of Medicaid Claims Processing jobs in Raleigh, NC? The most popular types of Medicaid Claims Processing jobs in Raleigh, NC are:
What are popular job titles related to Medicaid Claims Processing Remote jobs in Raleigh, NC? For Medicaid Claims Processing Remote jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Medicaid Claims Processing Remote jobs in Raleigh, NC look for? The top searched job categories for Medicaid Claims Processing Remote jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Medicaid Claims Processing Remote jobs? Cities near Raleigh, NC with the most Medicaid Claims Processing Remote job openings:
Medicaid Claims Processing Remote jobs near you
Infographic showing various Medicaid Claims Processing Remote job openings in Raleigh, NC as of August 2026, with employment types broken down into 82% Full Time, 9% Part Time, and 9% Contract. Highlights an 100% Remote job distribution, with an average salary of $38,750 per year, or $18.6 per hour.

AVP, AI (Data Science/Engineer) Remote - EST

Archgroup

Raleigh, NC • Remote

$185K - $235K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 12 days ago

Job description

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility.

Strategic Analytics is a dynamic and growing team at Arch that drives innovation and transforms how the business operates. We build AI-first, agent-driven products that change how Arch underwrites, services, and learns from its book, combining frontier LLMs, multi-agent systems, retrieval-augmented generation (RAG), evaluation frameworks, and traditional machine learning.Our mission spans agentic automation, decision intelligence, AI-driven insights, and the responsible deployment of AI at scale. With a proven track record of productionizing dozens of high-quality GenAI products over the past three years, we are continuing to scale our impact and are seeking an AVP, AI Engineering to lead the design and application of advanced AI systems within Strategic Analytics.

Reporting to the SVP of AI & Automation, you will lead the development of multi-agent AI solutions that automate complex business decisions across underwriting and claims. This role is focused on applying AI, machine learning, and data science to solve high-value business problems, establish decision frameworks, and ensure AI systems deliver measurable outcomes with high levels of accuracy and trustworthiness.

Key Responsibilities

Lead the design of multi-agent AI systems that coordinate specialized models and agents to solve complex business problems.

Drive the end-to-end delivery of AI-powered underwriting and claims solutions from experimentation through production deployment.

Develop and evaluate decision frameworks that combine LLMs, retrieval systems, machine learning models, business rules, and human review.

Establish methodologies for measuring model performance, calibration, confidence, accuracy, and business impact to determine when automation is appropriate.

Define the conditions under which AI-driven decisions should be trusted, reviewed, or escalated.

Partner with cross-functional teams to integrate AI capabilities into business workflows and operational processes.

Mentor data scientists, AI engineers, and analysts on agentic AI, model evaluation, prompt engineering, and responsible AI practices.

Establish standards for AI evaluation, monitoring, governance, and continuous improvement within the AI & Automation Center of Excellence.

Translate business opportunities into scalable AI solutions that deliver measurable business value.

Required Skills and Experience

7+ years of experience in AI, machine learning, data science, analytics, or related disciplines.

3+ years of people leadership experience.

Demonstrated experience building and deploying production-grade AI, machine learning, or agentic systems beyond proof-of-concept work.

Strong track record of developing supervised learning models (ML and/or GLMs) that have delivered measurable financial impact.

Deep understanding of model evaluation, experimentation, statistical analysis, and decision science.

Strong experience evaluating AI technologies, platforms, and vendors.

Strong Python experience for data science, machine learning, and AI development.

Exceptional problem-solving skills with the ability to frame ambiguous business challenges as analytical and AI opportunities.

Strong communication skills with the ability to influence technical and non-technical stakeholders.

Hands-on experience with modern AI technologies, including LLMs, RAG, agentic systems, evaluation frameworks, and emerging AI tooling.

Desired Skills and Experience

Familiarity with P&C insurance, including underwriting, claims, or the submission lifecycle.

Experience with retrieval-augmented generation (RAG), evaluation frameworks, and structured-output techniques.

Experience applying AI and machine learning within enterprise environments.

Experience leading multidisciplinary teams across data science, AI, analytics, and technology functions.

Demonstrated commitment to staying current with advancements in AI through research, experimentation, publications, conference participation, or contributions to the AI community.

Education

Bachelor's degree in Data Science, Computer Science, Statistics, Mathematics, Engineering, Analytics, or equivalent practical experience.

#LI-LH1

#LI-REMOTE

For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.

$185,000 - $235,000/year

  • Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.

  • Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.

Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you.If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.

10200 Arch Capital Services LLC

Apply