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Remote Claim Reviewer Jobs in Virginia (NOW HIRING)

SPECIALTY RX, Inc.

Pharmacy Billing Representative-Remote

Roanoke, VA · On-site +1

$17.50 - $22.75/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... and claim updates. * Investigate and resolve pending billing and insurance issues. * Work with ... Apply Here - SpecialtyRx Careers We look forward to reviewing your application and connecting with ...

New

SpecialtyRx, Inc.

Pharmacy Billing Representative-Remote

Roanoke, VA · Remote

$17.50 - $22.75/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... and claim updates. * Investigate and resolve pending billing and insurance issues. * Work with ... Apply Here - SpecialtyRx Careers We look forward to reviewing your application and connecting with ...

New

Erie Insurance

Property Adjuster I

Petersburg, VA · Remote

$55K - $88K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote Salary Range: $55,261.00 - $88,274.00 * salary range is for this level and may vary based on ... Obtains and reviews reports, statements, records and related materials as required. Evaluates ...

Erie Insurance

Property Adjuster I

Ashburn, VA · Remote

$67K - $108K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote Salary Range: $67,650.00 - $108,065.00 * salary range is for this level and may vary based ... Obtains and reviews reports, statements, records and related materials as required. Evaluates ...

Erie Insurance

Property Adjuster I

Charlottesville, VA · Remote

$56K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote Salary Range: $56,367.00 - $90,040.00 * salary range is for this level and may vary based on ... Obtains and reviews reports, statements, records and related materials as required. Evaluates ...

Erie Insurance

Property Adjuster I

Fairfax, VA · Remote

$67K - $108K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote Salary Range: $67,650.00 - $108,065.00 * salary range is for this level and may vary based ... Obtains and reviews reports, statements, records and related materials as required. Evaluates ...

Erie Insurance

Property Adjuster II

Newport News, VA · Remote

$60K - $96K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote Salary Range: $60,677.00 - $96,925.00 * salary range is for this level and may vary based on ... reserves, reviews reports and related materials, directs experts, determines coverage and claim ...

Sentara Healthcare

Benefits Coding Analyst

Richmond, VA · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This position is remote however, candidates must be able to commute to our Richmond location. The ... This role will assist in researching code updates, authorization requests, and claim questions ...

Riverside

$27.30 - $37.58/hr

FOR APPLICATION REVIEW - PROVIDE YOUR CODER CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUME This ... DNFB (discharged not final billed), Denials, and Claim Edits. * Participates in ongoing coding ...

Riverside Health System Non-Providers

$27.30 - $37.58/hr

FOR APPLICATION REVIEW - PROVIDE YOUR CODER CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUME This ... DNFB (discharged not final billed), Denials, and Claim Edits. * Participates in ongoing coding ...

USAA

Inside Senior Property Claims Adjuster

Chesapeake, VA · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Investigate claim damages by conducting research from various sources, including the insured, third ...

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Showing results 21-40

All JobsClaim Reviewer JobsRemote Claim Reviewer JobsRemote Claim Reviewer Jobs in Virginia

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 popular job titles related to Remote Claim Reviewer jobs in Virginia?

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

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

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

Remote Claim Reviewer jobs near you

Pharmacy Billing Representative-Remote

SPECIALTY RX, Inc.

Roanoke, VA • On-site, Remote

$17.50 - $22.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted yesterday

New

Job description

Description
Build Your Career with Us!
Competitive Pay • Stable Schedules • Career Growth • Multiple Shifts Available
SpecialtyRx is a fast-growing Long-Term Care pharmacy dedicated to providing personalized, high-quality pharmaceutical services to long-term care facilities and assisted living communities.
We are currently seeking a Third-Party Rejections Specialist to join our team. This role is focused specifically on hands-on third-party insurance rejection experience. If you have direct experience researching, resolving, and processing pharmacy insurance rejections, we want to hear from you!
Candidates must reside in Ohio, Virginia, or Kentucky.
What You'll Do
  • Perform duties and responsibilities assigned by the Billing Supervisor.
  • Research and verify patient eligibility and insurance coverage with state and private insurance providers.
  • Research, analyze, and resolve third-party insurance rejections in accordance with daily rejection reports.
  • Maintain and update patient billing, insurance, and coverage information in the system.
  • Submit and follow up on prior authorizations for state insurance programs.
  • Communicate directly with insurance companies regarding rejections, overrides, eligibility issues, coverage changes, and claim updates.
  • Investigate and resolve pending billing and insurance issues.
  • Work with client facility staff and other applicable healthcare organizations and agencies, including PDP/Medicare, CMS, NJM, and NYM, when necessary.
  • Maintain accurate documentation and ensure billing information is current and complete.
  • Work independently while collaborating with the billing team to meet daily goals and deadlines.
  • Handle multiple priorities in a fast-paced environment while maintaining accuracy and attention to detail.

Qualifications
Who We're Looking For
We're looking for detail-oriented professionals who understand how to work through third-party pharmacy claim rejections and are comfortable communicating with insurance providers to identify and resolve coverage and billing issues.
If your background is primarily in medical billing or medical coding, this position may not be the right fit. We are specifically seeking candidates with direct third-party pharmacy rejection experience.
Required:
  • High school diploma or equivalent.
  • Direct, hands-on experience working with third-party pharmacy insurance rejections is required.
  • Experience must be in actual third-party rejection processing/resolution.
  • Strong computer skills and ability to learn and navigate multiple systems.
  • Excellent attention to detail and problem-solving skills.
  • Professional and courteous telephone communication skills.
  • Ability to work independently and as part of a team.
  • Ability to multitask and prioritize work in a fast-paced environment.
  • Strong organizational skills and follow-through.

Preferred:
  • Previous pharmacy experience.
  • Long-Term Care Pharmacy experience.
  • Experience with New York pharmacy billing claims.
  • Frameworks/ECM experience.
  • Experience working directly with insurance providers to resolve pharmacy claim rejections.

Schedule
We are hiring for multiple shifts!
Candidates must have weekend availability. Flexibility to work evenings and/or overnight shifts is strongly preferred.
Available shifts may include:
  • 8:00 AM - 4:00 PM
  • 9:00 AM - 5:00 PM
  • 11:00 AM - 7:00 PM
  • 12:00 PM - 8:00 PM
  • 3:00 PM - 11:00 PM
  • 4:00 PM - 12:00 AM

What We Offer
  • Competitive pay based on experience.
  • Stable and consistent scheduling.
  • Opportunities for career growth.
  • Health, dental, and vision insurance.
  • Group life insurance and short-term disability.
  • Paid time off and paid holidays.
  • 401(k) with company match.
  • Paid training and development opportunities.
  • Collaborative and supportive work environment.

Ready to Join the SpecialtyRx Team?
Apply today through our careers portal:
Apply Here - SpecialtyRx Careers
We look forward to reviewing your application and connecting with qualified candidates to schedule an interview.
EEO Statement
SpecialtyRx, Inc. is fully committed to employing a diverse workforce. We recruit and retain talented individuals without regard to gender, race, age, marital status, disability, veteran status, sexual orientation, gender identity, or any other status protected by federal, state, or local law.
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