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Remote Claim Processor Jobs in Santa Clara, CA (NOW HIRING)

Deloitte

Epic Denials Management Operator

San Jose, CA · Remote

$21 - $28.25/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 ...

Gallagher

Risk Management Analyst

San Jose, CA · Remote

$80K - $120K/yr

... claim costs * Advise on compliance with FEHA and the Interactive Process for industrial-related ... Remote work environment flexibility. About You * Minimum of 5 years of experience with workers ...

Cisco

Analyst Relations Manager

San Jose, CA · On-site +1

$145K - $182K/yr

Remote United States Meet the Team Join Cisco's Analyst Relations team as a key member of the ... Manage the full RFI process for at least one Tier 1 evaluation annually, driving cross-functional ...

Acrisure

Workers' Compensation Case Manager

San Jose, CA · On-site +1

$70K - $90K/yr

This position is fully remote; however, candidates must be available to work a regular, consistent ... Strong understanding of workers' compensation processes, case management practices, and return to ...

Ross Stores, Inc

Lease Auditor

Dublin, CA · On-site +1

$62K - $101K/yr

Draft and send claim letters. Calculate and pay Substitute Rent if a co-tenancy violation exists ... Lead user acceptance testing process. Act as primary contact between Ross and its Landlords ...

MCKESSON

Field Reimbursement Manager

San Jose, CA · On-site +1

... remote interaction and on-site training. This position is client-facing and customer-facing and ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...

Ross Stores

Lease Auditor

Dublin, CA · On-site +1

$62K - $101K/yr

Draft and send claim letters. Calculate and pay Substitute Rent if a co-tenancy violation exists ... Lead user acceptance testing process. • Act as primary contact between Ross and its Landlords ...

Ross Stores

Lease Auditor

Dublin, CA · On-site +1

$62K - $101K/yr

Draft and send claim letters. Calculate and pay Substitute Rent if a co-tenancy violation exists ... Lead user acceptance testing process. Act as primary contact between Ross and its Landlords ...

All JobsClaim Processor JobsRemote Claim Processor JobsRemote Claim Processor Jobs in Santa Clara, CA

Remote Claim Processor information

See Santa Clara, CA salary details

$14

$22

$31

How much do remote claim processor jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for remote claim processor in Santa Clara, CA is $22.51, according to ZipRecruiter salary data. Most workers in this role earn between $19.18 and $24.28 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 Santa Clara, CA? For Remote Claim Processor jobs in Santa Clara, CA, the most frequently searched job titles are:
What job categories do people searching Remote Claim Processor jobs in Santa Clara, CA look for? The top searched job categories for Remote Claim Processor jobs in Santa Clara, CA are:
What cities near Santa Clara, CA are hiring for Remote Claim Processor jobs? Cities near Santa Clara, CA with the most Remote Claim Processor job openings:
Remote Claim Processor jobs near you
Infographic showing various Remote Claim Processor job openings in Santa Clara, CA as of August 2026, with employment types broken down into 73% Full Time, 9% Part Time, and 18% Contract. Highlights an 100% Remote job distribution, with an average salary of $46,817 per year, or $22.5 per hour.

Medical Billing Expert

Certified Employment Group Job Openings

Hayward, CA • On-site, Remote

$20 - $24/hr

Contractor

Re-posted 14 days ago

Job description

Medical Billing Expert
Location: Hayward, CA
Employment Type: Contract
Pay Range: $20-$24 per hour
 
Job Summary
The Medical Billing Expert is responsible for managing the medical billing process from claim creation through payment reconciliation. This role ensures accurate coding, timely claim submission, insurance verification, payment posting, denial management, and compliance with healthcare regulations. The ideal candidate has strong knowledge of medical billing practices, insurance guidelines, and revenue cycle management while maintaining excellent attention to detail and customer service.

Key Responsibilities
  • Prepare, review, and submit accurate medical claims to insurance carriers.
  • Verify patient insurance eligibility and benefits.
  • Process electronic and paper claims in a timely manner.
  • Monitor claim status and follow up on unpaid or denied claims.
  • Investigate and resolve billing discrepancies, claim rejections, and payment issues.
  • Post insurance and patient payments accurately.
  • Manage accounts receivable and work aging reports to reduce outstanding balances.
  • Communicate with insurance companies regarding claim status, authorizations, and appeals.
  • Respond to patient billing inquiries professionally and accurately.
  • Maintain compliance with HIPAA, Medicare, Medicaid, and commercial payer regulations.
  • Ensure accurate documentation and maintain billing records.
  • Collaborate with providers, coders, and administrative staff to resolve billing issues.
  • Generate billing and financial reports as requested.
  • Stay current on payer policies, coding updates, and industry regulations.
Required Qualifications
  • High school diploma or equivalent; associate degree or certification preferred.
  • 2+ years of experience in medical billing, healthcare revenue cycle, or related field.
  • Strong understanding of medical terminology, CPT, ICD-10, and HCPCS coding systems.
  • Knowledge of insurance claims processing, reimbursement methodologies, and payer requirements.
  • Experience with Electronic Health Record (EHR) and Practice Management (PM) systems.
  • Proficiency in Microsoft Office, particularly Excel.
  • Excellent analytical, organizational, and problem-solving skills.
  • Strong verbal and written communication skills.
  • High level of accuracy and attention to detail.
Preferred Qualifications
  • Certified Professional Biller (CPB) or similar certification.
  • Experience with Medicare, Medicaid, and commercial insurance billing.
  • Knowledge of prior authorization and appeals processes.
  • Experience with multi-specialty or high-volume medical practices.
Key Skills
  • Medical billing and claims processing
  • Revenue cycle management
  • Insurance verification
  • Denial management and appeals
  • Payment posting and reconciliation
  • Accounts receivable management
  • Medical coding knowledge (CPT, ICD-10, HCPCS)
  • HIPAA compliance
  • Data entry and documentation
  • Customer service
  • Time management
  • Problem-solving
  • Attention to detail
Working Conditions
  • Office or remote work environment, depending on organizational needs.
  • Standard business hours with occasional overtime during peak billing cycles.
  • Prolonged periods of sitting and computer use.
 
Certified Employment Group logo

About Certified Employment Group

Sourced by ZipRecruiter

Certified Employment Group started in San Francisco in 1963. Our cornerstone mission was, and remains, to provide ethical, caring service to each of our clients and employees. These values mean using technology to create efficiencies for our clients, expand our service offerings and enhance the level of service we can provide. As Northern California businesses have prospered, Certified has responded by opening branches to serve high-growth areas. We have expanded our services to include on-site management for major accounts, developing a web based interface and opening specialized divisions in Legal, Renewable Energy and Accounting. Certified remains independently owned, responsive, flexible and wholly committed to our original values. We believe this is the reason for our success. Industry rankings continually place Certified in the top ten percent based on sales!

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Emeryville, CA, US

Year founded

1963

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