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Remote Claim Reviewer Jobs (NOW HIRING)

Imagenet

Remote Claims QA Analyst

Omaha, NE · On-site +1

Ensure all reviewed processes align with applicable regulatory requirements. Participate in ... Experience with other claim adjudication platforms and provider systems. * Familiarity with DHCS ...

Imagenet

Remote Claims QA Analyst

Omaha, NE · Remote

Ensure all reviewed processes align with applicable regulatory requirements. Participate in ... Experience with other claim adjudication platforms and provider systems. * Familiarity with DHCS ...

ImageNetLLC

Remote Claims QA Analyst

Omaha, NE · Remote

Ensure all reviewed processes align with applicable regulatory requirements. Participate in ... Experience with other claim adjudication platforms and provider systems. * Familiarity with DHCS ...

The MH Group, LLC

$60K - $70K/yr

This is a fully remote position with a great company offering fantastic benefits. The Claims ... Review all claim-related compliance reports to ensure accuracy. * Scrub pay-related reports to ...

A-G Specialty Insurance, LLC

Claim Examiner

Berwyn, PA · Remote

$50K/yr

Establish proof of loss by reviewing medical documentation; assembling additional information as ... The role is open to candidates who are in a fully remote, hybrid, or on-site role. One full week of ...

Corvel

Claim Specialist Floater

Overland Park, KS · Remote

$25.48 - $41.09/hr

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms policy ... Adheres to client and carrier guidelines and participates in claims review as needed * Assists ...

Med Review Inc

Outpatient Coder Auditor

Manhattan, NY · Remote

$100K - $102.50K/yr

Familiarity with data analytics tools and claim review platforms. Prior experience in payment ... Remote Work Requirements High speed internet (100 Mbps per person recommended) with secured WIFI. A ...

Machinify

Nurse Itemized Bill Reviewer (IBR Analyst)

$80K - $90K/yr

Recommend system enhancements and edits to improve claim review efficiency. * Comply with company ... Proven success in a remote working environment * Proficient in Windows office systems, including ...

DMOS

Part Time Clinical Coder (Iowa Remote)

West Des Moines, IA · On-site +1

$17.25 - $21.75/hr

... claim was coded. After some on-site training, this position works from home (within the state of ... Review claims and make any necessary adjustments before closing a case * Be able to work remotely ...

New

CCMSI

Multi-Line Claim Consultant

Chicago, IL · On-site +1

$65K - $80K/yr

Chicago, IL (Hybrid or Remote) (Position may be performed anywhere within the state of Illinois ... Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ...

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All JobsRemote Claim Reviewer Jobs

Remote Claim Reviewer information

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$30.5K

$64.6K

$90K

How much do remote claim reviewer jobs pay per year?

As of May 31, 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.

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 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:
Remote Claim Reviewer jobs near you

Remote Claims QA Analyst

Imagenet

Omaha, NE • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 17 days ago

Job description

Claims Quality Analyst | Remote
Job Type: Full time
Work Setup: Remote
Reports to: Claims Supervisor
Position Summary:
The Claims Quality Analyst plays a key role in ensuring the accuracy, compliance, and effectiveness of claims processing and provider dispute resolution. The ideal candidate has hands on experience with EZCap, auditing claims, analyzing dispute claims and evaluating internal policies and regulatory requirements, with a particular focus on Medi-Cal and commercial health plans. This role is responsible to partners closely with cross-functional teams to drive continuous improvement and operational excellence.
Key Duties:
  • Perform detailed audits of denied, underpaid, and processed claims using EZCap to assess accuracy and compliance with provider contracts and regulatory guidelines.
  • Analyze provider disputes for patterns or recurring issues.
  • Identify root causes and work with relevant teams to implement corrective actions and process improvements.
  • Develop and track performance related to claims accuracy, turnaround time, and dispute resolution efficiency.
  • Conduct thorough root cause analyses on high-impact errors or escalations.
  • Support training initiatives by identifying knowledge gaps and assisting in the development of updated procedures and documentation based on audit results.
  • Ensure all reviewed processes align with applicable regulatory requirements. Participate in internal and external audits as needed.

Qualifications:
  • High school diploma or equivalent
  • At least 3-5 years of Quality Analyst in healthcare, TPA, or health plan settings/ healthcare claims or in a claims processing/adjudication environment
  • Hands-on experience with EZCap (strongly preferred)
  • Familiarity with Medi-Cal and Commercial insurance claim
  • Strong analytical and problem-solving skills
  • Excellent verbal and written communication
  • Attention to detail in documentation and compliance
  • Ability to manage multiple tasks and meet deadlines
  • Experience with other claim adjudication platforms and provider systems.
  • Familiarity with DHCS, DMHC, CMS dispute handling regulations.

What We Offer
  • Remote work offered
  • Equipment provided
  • Paid training to set you up for success
  • Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
  • Paid Time Off (PTO)
  • 7 paid holidays
  • A supportive team and a company that values internal growth

COMPANY OVERVIEW:
Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans' members and providers.
The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans' members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.
Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.

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