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Remote Claim Processor Jobs in Houston, TX (NOW HIRING)

PFS Group

Remote Insurance Rep

Houston, TX · Remote

$53K - $67K/yr

Monitors accounts for updates on claims processing, taking care to resolve balances with single interventions whenever possible * Request appropriate claim corrections and rebill as needed * Informs ...

Huntington

Trust Real Estate Asset Manager

Houston, TX · On-site +1

... process insurance coverages ensuring prudent values and coverages. Manage insurance claim ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Huntington

Trust Real Estate Asset Manager

Houston, TX · On-site +1

... process insurance coverages ensuring prudent values and coverages. Manage insurance claim ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Huntington

Trust Real Estate Asset Manager

Houston, TX · On-site +1

... process insurance coverages ensuring prudent values and coverages. Manage insurance claim ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Qcells

Director of EPC Warranties

Houston, TX · On-site +1

Hybrid/Remote DIRECTOR OF EPC WARRANTIES Hanwha Qcells USA Corp (Qcells USA), headquartered in ... of processes to track warranty claims and related KPIs Designs strategies to minimize the overall ...

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All JobsRemote Claim Processor JobsRemote Claim Processor Jobs in Houston, TX

Remote Claim Processor information

See Houston, TX salary details

$11

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How much do remote claim processor jobs pay per hour?

As of Jun 16, 2026, the average hourly pay for remote claim processor in Houston, TX is $18.30, according to ZipRecruiter salary data. Most workers in this role earn between $15.62 and $19.76 per hour, depending on experience, location, and employer.

What is the difference between Remote Claim Processor vs Remote Claims Examiner?

AspectRemote Claim ProcessorRemote Claims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance or healthcare certificationsHigh school diploma or equivalent; often requires insurance or healthcare-related certifications
Work EnvironmentHome-based, independent work settingHome-based, independent work setting
Industry UsageInsurance, healthcare, government agenciesInsurance, healthcare, government agencies
Job FocusProcessing insurance claims, data entry, verifying informationReviewing and adjudicating insurance claims, ensuring compliance

Both roles are remote positions within the insurance and healthcare industries, requiring similar credentials and work environments. The main difference lies in their focus: Remote Claim Processors handle initial claim processing and data entry, while Remote Claims Examiners review and make decisions on claims to ensure accuracy and compliance.

What is a Remote Claim Processor?

A Remote Claim Processor is a professional who reviews, evaluates, and processes insurance claims from a remote location, often from home. They verify the accuracy of submitted information, ensure policy guidelines are met, and decide whether claims should be approved, denied, or require further investigation. This role typically involves working with health, auto, or property insurance claims and requires strong attention to detail, analytical skills, and familiarity with relevant software systems. Working remotely allows claim processors to handle their duties outside of a traditional office environment while maintaining communication with their team and clients through digital platforms.

What are the key skills and qualifications needed to thrive as a Remote Claim Processor, and why are they important?

To thrive as a Remote Claim Processor, you need strong analytical skills, attention to detail, and a background in insurance or healthcare administration, typically supported by a high school diploma or relevant certification. Familiarity with claims management software, electronic health record (EHR) systems, and Microsoft Office is crucial for daily tasks. Excellent communication, problem-solving abilities, and self-motivation help remote claim processors efficiently resolve issues and work independently. These skills ensure accurate claims processing, timely resolution, and high customer satisfaction in a remote environment.

What are some common challenges faced by remote claim processors, and how can they be managed effectively?

Remote claim processors often encounter challenges such as maintaining effective communication with team members and staying up-to-date with changing insurance policies and procedures. To manage these challenges, it's important to leverage collaboration tools like instant messaging and video conferencing, and to participate actively in virtual training sessions. Additionally, setting up a dedicated workspace and following a structured daily routine can help ensure productivity and accuracy when processing claims remotely.
What are popular job titles related to Remote Claim Processor jobs in Houston, TX? For Remote Claim Processor jobs in Houston, TX, the most frequently searched job titles are:
What job categories do people searching Remote Claim Processor jobs in Houston, TX look for? The top searched job categories for Remote Claim Processor jobs in Houston, TX are:
What cities near Houston, TX are hiring for Remote Claim Processor jobs? Cities near Houston, TX with the most Remote Claim Processor job openings:
Remote Claim Processor jobs near you

Workers Compensation Claims Examiner (TEXAS Jurisdiction)

Elite

Houston, TX • Remote

$31.25 - $42.50/hr

Other

Medical

Posted 10 days ago

Job description

POSITION DETAILS
POSITION SUMMARY
COMPANY has an immediate need for a full-time Senior Claims Examiner to support our workers compensation department. This position is offered as a fully remote work from home opportunity and the schedule for this position is Monday-Friday at 37.5 hours a week. The Senior Claims Examiner will adjust workers' compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements.
PRIMARY RESPONSIBILITIES
Candidates should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
  • Process new claims in compliance with client's Service Agreement
  • Establish contact with employer to review issues
  • Respond to inquiries from the employer, employee, doctors, and attorneys
  • Establish and maintain appropriate reserves
  • Review legal correspondence and medical reports
  • Evaluate and approve medical procedures and treatment
  • Administer benefits and ensure appropriateness of all payments
  • Investigate coverage, liability, and monetary value of claim
  • Review medical and legal bills for appropriateness
  • Discuss appropriateness of medical treatment with medical case manager
  • Determine compensability
  • Monitor and assist litigation
  • Negotiate settlement of claim, liens, rehabilitation plans, etc.
  • Prepare and present reports to clients
  • Appropriately close claims
  • Help resolve client billing and payment inquiries
  • Investigate complaints from injured workers
  • Document and code the claim files and claims system with all relevant information
  • Maintain and update action plans within specified time frames
  • Provide direction to Claims Assistants and Claims Technicians and assist with training, coaching, and mentoring as needed for them to support daily claims tasks
  • Contact with employers, employees, attorneys, doctors, vendors and other parties
  • Provide customer service and support to clients and claimants
  • Work collaboratively with attorneys to draft settlements and assist with litigation strategies
  • Negotiate settlements
  • Authorize and negotiate cost of medical treatment and supplies
  • Internal communication with staff
  • Prepare professional, well written correspondence and other communications

ESSENTIAL POSITION REQUIREMENTS
The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
  • High School Diploma or equivalent (GED) required for all positions
    • AA/AS or BA/BS preferred but not required
  • The Texas 03 Workers' Compensation license is required
    • The 08 All Lines License is preferred
  • 3+ years recent workers compensation claims handling experience required
  • At least 5 years of workers compensation claims experience preferred
  • Solid knowledge of workers compensation laws, policies, and procedures'
  • Completion of IEA or equivalent courses
  • Proficiency in determining case value and negotiating settlements
  • Understanding of medical and legal terminology
  • Mathematical calculating skills
  • Well-developed verbal and written communication skills with strong attention to detail
  • Excellent organizational skills and ability to multi-task
  • Ability to type quickly, accurately and for prolonged periods
  • Proficient in Microsoft Office Suite
    • Ability to learn additional computer programs
  • Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
  • Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
  • Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
  • Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
  • Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor.
  • COMPANYs' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
  • Must be able to reliably commute to meetings and events as required by this position

This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.
COMPANY is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
COMPANY is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc.

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