ZipRecruiter

Log In

2

Remote Claim Reviewer Jobs in Ohio (NOW HIRING)

Ovationhealthcare

Specialist, Billing

Mount Vernon, OH · Remote

$16 - $21.75/hr

... reviews and resolves billing daily claim edits and ensuring compliance with Insurance billing ... Work from home and remote location with a stable internet connection, a quiet and dedicated ...

Posted today

Manulife

Senior Underwriting Consultant

New Hampshire, OH · On-site +1

$88K - $104K/yr

This is a remote role open to any location in continental US Manulife is a leading international ... May process all aspects of auditing, formal appeal reviews and contestable claim review. * Audit ...

Manulife

Senior Underwriting Consultant

Delaware, OH · On-site +1

$93K - $110K/yr

This is a remote role open to any location in continental US Manulife is a leading international ... May process all aspects of auditing, formal appeal reviews and contestable claim review. * Audit ...

USAA

Sr. TLE Auto Appraiser

Toledo, OH · On-site +1

$63K - $121K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Reviews facts of loss and vehicle damage to determine if subrogation opportunities exist and ...

Deloitte

Epic Denials Management Operator

Columbus, OH · Remote

$17.50 - $23.25/hr

This is a primarily remote role supporting enterprise Epic support, with minimal travel and ... Review hospital account records and payer remittance records, communicate with relevant Client RCM ...

Deloitte

Epic Denials Management Operator

Cleveland, OH · Remote

$17.50 - $23.25/hr

This is a primarily remote role supporting enterprise Epic support, with minimal travel and ... Review hospital account records and payer remittance records, communicate with relevant Client RCM ...

Deloitte

Epic Denials Management Operator

Dayton, OH · Remote

$17.50 - $23.25/hr

This is a primarily remote role supporting enterprise Epic support, with minimal travel and ... Review hospital account records and payer remittance records, communicate with relevant Client RCM ...

Deloitte

Epic Denials Management Operator

Cincinnati, OH · Remote

$17.25 - $23/hr

This is a primarily remote role supporting enterprise Epic support, with minimal travel and ... Review hospital account records and payer remittance records, communicate with relevant Client RCM ...

centralins

Anti-Fraud Manager

Dublin, OH · On-site +1

Hybrid or Remote based on location Position type: Full time - salary We're a team of employees ... Reviews and evaluates all available information to assess the appropriateness of referrals for ...

next page

Showing results 1-20

All JobsClaim Reviewer JobsRemote Claim Reviewer JobsRemote Claim Reviewer Jobs in Ohio

Remote Claim Reviewer information

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 are the most commonly searched types of Claim Reviewer jobs in Ohio?

The most popular types of Claim Reviewer jobs in Ohio are:

What are popular job titles related to Remote Claim Reviewer jobs in Ohio?

For Remote Claim Reviewer jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Remote Claim Reviewer jobs in Ohio look for?

The top searched job categories for Remote Claim Reviewer jobs in Ohio are:

Remote Claim Reviewer jobs near you

PA Workers' Compensation Medical Only Adjuster (Remote)

CCMSI

Dublin, OH • Remote

$45K - $55K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

Job description

OverviewClaim Representative, Medical Only - Pennsylvania Workers' Compensation Location: RemoteSchedule: Monday-Friday, 8:00am - 4:30pm ESTSalary Range: $45,000 - $55,000 annually, paid hourly (37.5 hours per week)Build Your Career With Purpose at CCMSIAt CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary 

The Medical Only Claim Representative is responsible for the handling and administration of Pennsylvania Workers' Compensation medical-only claims within a dedicated carrier program. This role manages a high-volume inventory of claims while ensuring timely, accurate, and compliant claim handling.

Working closely with claim staff and internal business partners, the Medical Only Claim Representative supports the claim process from initial assignment through closure by coordinating medical treatment, reviewing documentation, managing claim activity, and maintaining accurate claim records.

This position is ideal for individuals who have workers' compensation experience, strong organizational skills, and an interest in growing their claims career. It offers valuable exposure to claim handling while developing the technical knowledge needed for advancement into more complex adjusting roles.

ResponsibilitiesWhen we hire claim reps at CCMSI, we look for detail oriented professionals who understand that every task supports a real person's claim experience, value accuracy and responsiveness, and contribute to the team's success through organization, collaboration, and a strong commitment to service. 
  • Manage Pennsylvania Workers' Compensation medical-only claims from assignment through closure
  • Review claim information and supporting documentation to ensure accurate claim setup and handling
  • Coordinate and monitor medical treatment activities in accordance with claim handling standards
  • Review and process medical bills, invoices, and claim-related documentation
  • Maintain timely diary management and claim file documentation
  • Summarize medical records, correspondence, and claim activities within the claim system
  • Communicate with medical providers, employers, and internal claim partners as needed
  • Monitor claim activity and identify opportunities for closure or escalation
  • Assist claim staff with claim support activities and special projects
  • Maintain compliance with Pennsylvania Workers' Compensation regulations, Corporate Claim Standards, and client-specific handling instructions
  • Provide responsive service and support while maintaining quality and productivity expectations
QualificationsRequired: 
  • Associate degree or two years of related business, insurance, healthcare, claims, customer service, or administrative experience
  • Knowledge of Pennsylvania Workers' Compensation claims or workers' compensation processes
  • Strong attention to detail and organization skills
  • Ability to manage a high-volume workload efficiently and accurately
  • Strong written and verbal communication skills
  • Ability to prioritize multiple tasks and deadlines
  • Proficiency with Microsoft Office applications including:
    • Outlook
    • Word
    • Excel
  • Ability to work independently in a remote environment
  • Reliable attendance during established business hours
Nice to Have:  
  • Prior Pennsylvania Workers' Compensation experience
  • Medical-only claim handling experience
  • Carrier or TPA claim experience
  • Knowledge of medical terminology
  • Experience reviewing medical bills, treatment records, and claim documentation
  • Experience working within a dedicated client or carrier program
  • Interest in developing a long-term career in Workers' Compensation claims
Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required.  Why You'll Love Working Here  4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year  Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance  Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)  Career growth: Internal training and advancement opportunities  Culture: A supportive, team-based work environment  How We Measure SuccessAt CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:   Quality claim handling - thorough investigations, strong documentation, well-supported decisions  Compliance & audit performance - adherence to jurisdictional and client standards  Timeliness & accuracy - purposeful file movement and dependable execution  Client partnership - proactive communication and strong follow-through  Professional judgment - owning outcomes and solving problems with integrity  Cultural alignment - believing every claim represents a real person and acting accordingly  This is where we shine, and we hire adjusters who want to shine with us.

 

Compensation & ComplianceThe posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.Our Core ValuesAt CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:  
  • Lead with transparency We build trust by being open and listening intently in every interaction. 
  • Perform with integrity We choose the right path, even when it is hard. 
  • Chase excellence We set the bar high and measure our success. What gets measured gets done. 
  • Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. 
  • Win together Our greatest victories come when our clients succeed. 
We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #TPA #WorkersCompensation #WorkersCompClaims #MedicalOnlyClaims #WorkersCompAdjuster #ClaimRepresentative #PennsylvaniaWorkersComp #PAWorkersComp #CarrierClaims #ClaimsCareers #InsuranceCareers #RemoteJobs #HiringNow #LIRemote #IND123Employment Type: OTHER

Apply