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Remote Claim Reviewer Jobs (NOW HIRING)

MedReview

DRG Reviewer

Manhattan, NY · Remote

This is a fully remote position. Candidates must be available to work Eastern Standard Time (EST ... Maintains 95% accuracy in claim reviews. * Must be available to work a 7.5-hour workday during ...

MedReview

DRG Reviewer

Manhattan, NY · On-site +1

$85K - $90K/yr

This is a fully remote position. Candidates must be available to work Eastern Standard Time (EST ... Maintains 95% accuracy in claim reviews. * Must be available to work a 7.5-hour workday during ...

INSURICA, Inc

Senior Claim Consultant

Richardson, TX · Remote

$63K - $81K/yr

Review all loss details for clarification of expenses versus indemnity on loss runs or closing ... Remote work opportunities vary by location, department, and business need and are subject to change ...

Berkley

Claims Analyst

Manchester, NH · Remote

$70K - $80K/yr

... Remote The company is an equal employment opportunity employer. As a Stop Loss Claims Auditor (a.k.a. "Claims Analyst") , you'll perform quality review and evaluation of all claim submissions ...

Berkley

Claims Analyst

Manchester, NH · Remote

$70K - $80K/yr

... Remote The company is an equal employment opportunity employer. Responsibilities As a Stop Loss Claims Auditor (a.k.a. "Claims Analyst") , you'll perform quality review and evaluation of all claim ...

Aon Corporation

Claim Professional I

TX · Remote

$23.75 - $32.75/hr

The position will support multiple projects from remote base work location, with required travel as ... Conducts regular claim reviews, claim audits and prepares related reports. * Interfaces with ...

Aon

Claim Professional I

The position will support multiple projects from a remote base work location, with required travel ... Conducts regular claim reviews, claim audits and prepares related reports. * Interfaces with ...

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Remote Claim Reviewer information

See salary details

$30.5K

$64.6K

$90K

How much do remote claim reviewer jobs pay per year?

As of Aug 1, 2026, the average yearly pay for remote claim reviewer in the United States is $64,609.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,000.00 and $75,500.00 per year, depending on experience, location, and employer.

How can I get a legitimate remote job?

To secure a legitimate remote claim reviewer position, focus on building relevant skills such as claims processing, attention to detail, and familiarity with insurance software. Search for remote job listings on reputable job boards, verify the company's legitimacy, and be cautious of scams. Having a reliable internet connection and a suitable home workspace also supports remote work success.

What does a claims reviewer do?

A claims reviewer evaluates insurance claims to determine their validity and ensure they meet policy requirements. They review documentation, verify information, and decide whether to approve, deny, or request additional details, often using specialized software and adhering to company policies and industry regulations.

How can I make 2000 a week working from home?

A remote claim reviewer can potentially earn $2,000 a week by handling a high volume of claims, gaining experience, and working full-time hours. Increasing efficiency, developing specialized knowledge, and working for companies that pay competitive rates can help achieve higher earnings. Certifications in claims processing or insurance can also improve earning potential.

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

AspectRemote Claim ReviewerRemote Claims Processor
Required CredentialsHigh school diploma or equivalent; insurance knowledge often preferredHigh school diploma or equivalent; basic insurance or data entry skills
Work EnvironmentHome-based, independent review settingHome-based, processing claims and data entry
Industry UsageInsurance companies, third-party administratorsInsurance companies, healthcare providers
Common Search IntentComparing roles involving claim review and evaluationRoles focused on processing and data entry of claims

The main difference is that Remote Claim Reviewers evaluate and assess insurance claims for accuracy and validity, often requiring insurance knowledge. Remote Claims Processors handle the entry and processing of claims, focusing on data entry and administrative tasks. Both roles are remote and industry-specific but differ in responsibilities and skill requirements.

What companies hire remote claims adjusters?

Remote claims adjusters are hired by insurance companies, third-party claims organizations, and independent adjusting firms. Major insurers and specialized claims companies often offer remote positions that require knowledge of claims processing, insurance policies, and relevant certifications. These roles typically involve reviewing claims, assessing damages, and working with digital tools from home.
More about Remote Claim Reviewer jobs
What cities are hiring for Remote Claim Reviewer jobs? Cities with the most Remote Claim Reviewer job openings:
What are the most commonly searched types of Claim Reviewer jobs? The most popular types of Claim Reviewer jobs are:
What states have the most Remote Claim Reviewer jobs? States with the most job openings for Remote Claim Reviewer jobs include:
What job categories do people searching Remote Claim Reviewer jobs look for? The top searched job categories for Remote Claim Reviewer jobs are:
Remote Claim Reviewer jobs near you

Medical Claim Reviewer (CGS, DMEC-B)

Broadway Ventures

OR • Remote

Other

Re-posted 6 days ago

Job description

Max Salary: W-2 ($65,000/$31.25)

Location: Remote (U.S. - Work from home)
Remote Work Requirements: High-speed internet (non-satellite) and a private, lockable home office
Equipment: You will be provided with all necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed.

About the Role

We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements.

Key Responsibilities
  • Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
  • Assess payment determinations using clinical information and established guidelines.
  • Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
  • Provide clear, well-documented rationales for service approvals or denials.
  • Educate internal and external teams on medical review processes, coverage determinations, and coding requirements.
  • Support quality control activities to meet corporate and team objectives.
  • Provide guidance to LPN team members and support non-clinical staff through training and discussions.
  • Assist with special projects and additional responsibilities as assigned.
Minimum QualificationsLicensure:
  • Active, unrestricted RN license in the U.S. and in the state of hire
    OR
  • Active compact multistate RN license (as defined by the Nurse Licensure Compact).
Education:
  • Associate Degree in Nursing
    OR
  • Graduate of an accredited School of Nursing.
Experience:
  • Two years of clinical experience.
Skills & Competencies:
  • Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings.
  • Ability to interpret and apply medical review criteria and clinical guidelines.
  • Proficiency in Microsoft Office and word processing software.
  • Strong analytical, organizational, and decision-making skills.
  • Ability to work independently while managing priorities effectively.
  • Excellent customer service, communication, and critical thinking skills.
  • Ability to handle confidential information with discretion.

Apply