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Remote Adjudication Jobs (NOW HIRING)

Imagenet

Claims Examiner - Remote

Tampa, FL · On-site +1

Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ... Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive ...

RemX

Remote Healthcare Insurance Specialist

Phoenix, AZ · On-site +1

$17/hr

This is Remote ! PAID weekly!!!! Position: Medical Insurance Specialist Pay: $17/hr. Weekly Pay ... Insurance Verification and claim adjudication or medical billing * Experience or knowledge of ICD ...

Link Up Overseas

Customer Service Representative (Remote)

$16.50 - $22.25/hr

Customer Service Representative (Remote) Indianapolis, IN, United States Or refer someone Job ... Submit claims for adjudication, correction, payment, or review as appropriate. * Educate providers ...

Imagenet

Claims Examiner - Remote (Alameda)

Tampa, FL · Remote

Understanding of health claims processing/adjudication * Ability to perform basic to intermediate ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...

New

RemX

Remote Healthcare Case Manager $19/hr

Phoenix, AZ · On-site +1

$19/hr

Location: Remote Equipment: Provided and Shipped Start Date: TBD Job Duties include: * Prior ... Insurance Verification and claim adjudication or medical billing * Experience or knowledge of ICD ...

Integrated Management Strategies LLC

Remote Medical Coder

$19.25 - $24.25/hr

The role is fully remote within the US. We are proud of our national presence, and excited to offer ... adjudication. * Complete training on all government systems, including all annual and short notice ...

RemX

Remote Case Manager $19/hr!

Scottsdale, AZ · On-site +1

$19/hr

Location: 100% Remote?? Equipment: Provided & Shipped to You ?? Schedule: Monday-Saturday | Shifts ... Insurance verification, claims adjudication, or medical billing experience ?? Knowledge of ICD-10, ...

New

Tango Care

Manager, Claims (Remote)

Phoenix, AZ · On-site +1

Remote Responsibilities and Duties : Responsibilities include, but are not limited to the following ... Oversee batch assignments, batch-closure operations, adjudication runs and claims reconciliation ...

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Remote Adjudication information

What is the difference between Remote Adjudication vs Remote Claims Processor?

AspectRemote AdjudicationRemote Claims Processor
CredentialsTypically requires healthcare or insurance industry certificationsRequires insurance or claims processing knowledge, often with certification
Work EnvironmentPrimarily analyzing and making decisions on claims remotelyProcessing and reviewing insurance claims remotely
Industry UsageCommon in healthcare, insurance, and government sectorsCommon in insurance companies and third-party administrators
Search/Comparison IntentUnderstanding roles involving claim decision-making remotelyUnderstanding roles focused on processing insurance claims remotely

Remote Adjudication involves analyzing and making decisions on claims, often requiring specialized certifications. Remote Claims Processors handle the review and processing of claims, focusing on data entry and verification. While both roles work remotely within the insurance or healthcare industry, adjudicators focus on decision-making, whereas claims processors handle the administrative processing of claims.

More about Remote Adjudication jobs
What cities are hiring for Remote Adjudication jobs? Cities with the most Remote Adjudication job openings:
What are the most commonly searched types of Adjudication jobs? The most popular types of Adjudication jobs are:
What states have the most Remote Adjudication jobs? States with the most job openings for Remote Adjudication jobs include:
What job categories do people searching Remote Adjudication jobs look for? The top searched job categories for Remote Adjudication jobs are:
Remote Adjudication jobs near you
Infographic showing various Remote Adjudication job openings in the United States as of August 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 74% Physical, 4% Hybrid, and 22% Remote job distribution.

Claims Examiner - Remote

Imagenet

Tampa, FL • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago

Job description

Claims Examiner - Remote
Job Type: Full-time
Work Setup: This is a fully remote position
Work Hours: Pacific Time Zone
We are looking for Experienced Claims Examiner to join our rapidly growing team.
Experience is required for this position.
Job Overview:
As a Claims Examiner, you will be responsible for accurately reviewing, investigating, and processing medical claims and provider dispute requests in accordance with payer guidelines, contractual agreements, regulatory requirements, and internal policies.
Responsibilities:
  • Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.
  • Review and investigate provider dispute requests, appeals, and reconsiderations related to processed medical claims.
  • Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
  • Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues.
  • Participate in ongoing training and professional development activities.
  • Maintain accurate and detailed records of claims processing activities.
  • Review claim forms and supporting documents
  • Determine eligibility, verify data accuracy
  • Request additional information when needed
  • Process claims end-to-end
  • Identify and escalate complex or unusual claims for further review or investigation.
  • Participate in ongoing training and professional development activities.
  • Handle more complex claims with multiple services, providers

Experience:
  • At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment.
  • Experience processing Provider Dispute Resolution (PDR), appeals, reconsiderations, or claim adjustments is highly preferred.
  • Understanding of health claims processing/adjudication
  • Ability to perform basic to intermediate mathematical computation routines
  • Medical terminology strongly preferred
  • Understanding of ICD-9 & ICD-10
  • Basic MS office computer skills
  • Ability to work independently or within a team
  • Time management skills
  • Written and verbal communication skills
  • Attention to detail
  • Must be able to demonstrate sound decision-making skills

What We Offer
  • Remote work offered
  • Equipment provided
  • Paid training to set you up for success
  • Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
  • Paid Time Off (PTO)
  • 7 paid holidays
  • A supportive team and a company that values internal growth

Ready to Grow Your Career?
We'd love to meet you! Click "Apply Now" and tell us why you'd be a great addition to the Imagenet team.
About Imagenet, LLC
Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans' members and providers.
The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans' members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.
Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.

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