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Remote Claim Processor Jobs in Raleigh, NC (NOW HIRING)

Deloitte

Epic Denials Management Operator

Raleigh, NC · Remote

$17.50 - $23.25/hr

... claim issues, or operational data For individuals assigned and/or hired to work in a remote role ... 277 processing) received from third party payers. Conduct Denial categorization and root cause ...

Oshi Health

Accounts Receivable Specialist

Raleigh, NC · Remote

$19.75 - $26/hr

... processing, and payer reimbursement. * Experience resolving claim denials, underpayments, and ... Remote-first -- work from home within our approved states * Growth: Tailored professional ...

AMM Healthcare

RCM Coder

Cary, NC · Remote

$17.25 - $23.25/hr

This is a remote position and candidates must be located in North Carolina. Essential Functions ... Work with providers to correct the diagnosis or procedure codes so that the claim can be processed.

Atlantic Medical Management

RCM Coder

Cary, NC · Remote

$17.25 - $23.25/hr

This is a remote position and candidates must be located in North Carolina. Essential Functions ... Work with providers to correct the diagnosis or procedure codes so that the claim can be processed.

Hitachi

Senior Program Manager

Raleigh, NC · Remote

$112K - $113K/yr

Remote - North Carolina, United States Job ID: R0136213 Date Posted: 2026-07-31 Company Name ... Apply contract and claim management best practices to support business objectives. Your background

TEKsystems

Revenue Integrity Manager

Raleigh, NC · Remote

$86K - $142K/yr

... processes to ensure accurate claim submission, appropriate distribution of information, and ... Workplace Type This is a fully remote position. Application Deadline This position is anticipated ...

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All JobsClaim Processor JobsRemote Claim Processor JobsRemote Claim Processor Jobs in Raleigh, NC

Remote Claim Processor information

See Raleigh, NC salary details

$11

$18

$25

How much do remote claim processor jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for remote claim processor 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 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 skills and qualifications are needed to thrive as a remote claim processor?

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 common challenges faced by remote claim processors, and how can they be managed?

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 Raleigh, NC? For Remote Claim Processor jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Remote Claim Processor jobs in Raleigh, NC look for? The top searched job categories for Remote Claim Processor jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Claim Processor jobs? Cities near Raleigh, NC with the most Remote Claim Processor job openings:
Remote Claim Processor jobs near you
Infographic showing various Remote Claim Processor job openings in Raleigh, NC as of August 2026, with employment types broken down into 78% Full Time, 19% Part Time, and 3% Contract. Highlights an 85% Physical, 5% Hybrid, and 10% Remote job distribution, with an average salary of $38,750 per year, or $18.6 per hour.

Customer Service Supervisor PBM

Marpai Administrators LLC

Cary, NC • Remote

$58K - $65K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 23 days ago

Job description


Marpai Administrators (Subsidiary of Marpai Inc. (NASDAQ: MRAI)) is a technology company transforming the Third Party Administration sector serving employers with self-funded health plans. Marpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. We create healthier members and a healthier bottom line. Marpai proactively targets at-risk members with meaningful clinical interventions to improve outcomes. 
 
ABOUT THE POSITION: 
 
The Customer Service Supervisor, PBM reports to the Customer Service Manager and is responsible for leading a team of specialized agents, customer service representatives, to deliver high-quality service to resolve complex questions regarding prescription drug coverage. This role plays a critical part in enhancing customer satisfaction, driving retention, and supporting the overall business objectives by maintaining efficient operations and fostering a positive team environment. 
 
WHAT YOU WILL BE DOING: 
 
  • Supervise team: Guide the team through complex member inquiries regarding drug formularies, tier structures, and copays. Supervise the investigation and resolution with members, pharmacies and prescribers of rejected pharmacy claims, coordinating eligibility overrides and technical point-of-sale errors. 
  • Enforce compliance with regulatory requirements: Monitor and train teams on strict adherence to HIPAA regulations and other applicable regulations.
  • Monitor Key Performance Indicators (KPI) and Service Level Agreements (SLA): Ensure the team meets contractual SLAs. 
  • Training and Coaching: Analyze trends of issues to identify, training gaps, performance issues, and create a plan to address the gaps and recommend solutions as needed. Provide coaching and critical conversations to direct reports for developmental and correctional issues. 
  • Quality assurance and audits: Complete monthly call monitoring. Review monthly scorecard with individuals on team, identifying trends that need to be addressed as well as kudos for jobs well done.
  • Handles overflow for calls, chat, and emails as needed especially during peak
  • Maintain and develop Standard Operating Procedures
  • Other duties as required
 
WHAT SUCCESS LOOKS LIKE: 
 
  • Drive member accessibility through effectively managing resources, coordinating multiple daily tasks, and enhancing the effectiveness of customer interactions
  • Ensure exceptional quality through the monitoring and coaching of call interactions and claim processing
  • Cultivate the ultimate customer experience by ensuring the team is well trained and coached
  • Ensure team is meeting and exceeding expectations and metrics
 
WHAT DO YOU NEED:
  • Industry Experience: 2+ years of experience in a PBM, managed care, healthcare call center, or pharmacy environment.
  • Preferred License: Active Certified Pharmacy Technician (CPhT) designation or state pharmacy technician license is highly preferred. 
  • 3 years minimum call center experience
  • 3+ years in a supervisory or leadership role in a call center
  • Strong leadership and team management skills
  • Excellent communication, both verbal and written
  • Problem-solving and conflict resolution skills
  • Ability to analyze performance metrics and use data to improve team effectiveness
  • Encourage and support accountability and engagement, including sharing of information, ownership and successes with others
  • Consistently communicate expectations to clients and internal team members
  • Capability to manage service recovery as necessary

WORK REQUIREMENTS:
  • Tampa, FL or Remote
  • Fast paced, dynamic work environment requiring the ability to be adaptive, innovative and flexible
  • No travel required 
 
 WHY WORK AT MARPAI?  
We have great benefits: 
  • Generous PTO
  • Medical and Prescription 
  • Health and Wellness Programs 
  • EAP 
  • FSA / HSA / Dependent Care
  • Dental 
  • Vision 
  • Life and Disability 
  • STD/LTD
  • Voluntary Benefits: Critical Illness, Accident, Hospital
  • 401k with Employer Match
  • LegalShield 
  • Identity Theft Protection
       
    Marpai is an equal opportunity workplace.  We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.
     
     

This is a remote position.