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Remote Claims Associate Jobs (NOW HIRING)

Humana

Claims Processing Representative

Louisville, KY · On-site +1

As a Claims Processing Representative 2 you will: * Determine whether to return, deny, or pay ... Remote Work at Home Requirements To ensure Home or Hybrid Home/Office associates' ability to work ...

Humana

Claims Processing Representative

Louisville, KY · On-site +1

$40K - $52.30K/yr

As a Claims Processing Representative 2 you will: * Determine whether to return, deny, or pay ... Remote Work at Home Requirements To ensure Home or Hybrid Home/Office associates' ability to work ...

Humana

Claims Processing Representative

Louisville, KY · On-site +1

As a Claims Processing Representative 2 you will: * Determine whether to return, deny, or pay ... Remote Work at Home Requirements To ensure Home or Hybrid Home/Office associates' ability to work ...

Aegon

Senior Claims Examiner

Cedar Rapids, IA · On-site +1

$48K - $55K/yr

Associate's degree in a business field or equivalent experience * Five years of claims experience ... Remote/Hybrid The Salary for this position generally ranges between$48,000-55,000 annually. Please ...

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How much do remote claims associate jobs pay per hour?

As of Jun 1, 2026, the average hourly pay for remote claims associate in the United States is $20.99, according to ZipRecruiter salary data. Most workers in this role earn between $17.07 and $23.08 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Claims Associate, and why are they important?

To excel as a Remote Claims Associate, you typically need knowledge of insurance processes, attention to detail, and a high school diploma or relevant experience. Familiarity with claims management software, CRM systems, and sometimes specific certifications like AIC (Associate in Claims) are highly beneficial. Strong organizational skills, effective communication, and the ability to work independently are crucial soft skills for remote success. These competencies ensure accurate claims processing, customer satisfaction, and efficient remote workflow management.

How does a Remote Claims Associate typically collaborate with other team members while working from home?

As a Remote Claims Associate, you'll regularly communicate with team members, supervisors, and other departments through digital channels like email, instant messaging, and video conferencing. Collaboration often involves sharing updates on claim statuses, seeking guidance on complex cases, and participating in virtual team meetings. Many organizations use workflow management platforms and secure document-sharing tools to ensure seamless coordination and maintain data security. Building strong virtual communication skills is important to stay connected and contribute effectively to team goals.

What is a Remote Claims Associate?

A Remote Claims Associate is a professional who reviews, processes, and manages insurance claims from a remote location, typically working from home. They evaluate claim details, verify information, and communicate with policyholders, service providers, and other stakeholders to ensure claims are handled accurately and efficiently. This role often requires strong attention to detail, good communication skills, and proficiency with digital tools and claims management software. Remote Claims Associates may work for insurance companies, third-party administrators, or other organizations handling claims. The position allows for flexibility in work location while maintaining high standards of customer service and accuracy.

Can claims adjusters work remotely?

Yes, many claims adjusters work remotely, especially in roles that involve reviewing claims, communicating with clients, and using claims management software. Remote work arrangements are common in the insurance industry and often require strong communication skills and familiarity with digital tools.
More about Remote Claims Associate jobs
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Remote Claims Associate jobs near you
Infographic showing various Remote Claims Associate job openings in the United States as of May 2026, with employment types broken down into 86% Full Time, 7% Part Time, and 7% Contract. Highlights an 74% Physical, 9% Hybrid, and 17% Remote job distribution, with an average salary of $43,653 per year, or $21 per hour.
Provider Claims Service Representative

Provider Claims Service Representative

Amerihealth Caritas

Philadelphia, PA • On-site, Remote

Full-time

Medical, Retirement, PTO

Posted 18 days ago

AmeriHealth Caritas rating

8.5

Company rating: 8.5 out of 10

Based on 69 frontline employees who took The Breakroom Quiz

86th of 259 rated insurance

Job description

Responsibilities: 
 
Under the general direction of the Operations Call Center Supervisor, responsible for responding in a timely, professional and courteous manner to all customer needs. This includes provider phone calls or correspondence regarding benefit, eligibility, and other provider issues.  Reviews and adjudicates claims based on provider and healthplan contractual agreements and claims processing guidelines.  Serves as a Subject Matter Expert.  Conducts cross training to staff as required.  Demonstrates solid knowledge of Provider Service/Claim systems, functions and team process.  Demonstrates superior skill in dealing with provider issues/inquiries, team members, and co-workers.
 
  • Suspends claims requiring additional information and/or special handling; initiates action to obtain required information.
  • Forwards claims requiring external department intervention to the appropriate department or person.
  • Monitors outstanding inquiries and works with management staff to identify and resolve areas of non-compliance.
  • Reviews and verifies quality audit reports.
  • Reconciles audit discrepancies, corrects in system and make appropriate changes to avoid recurrence.
  • Maintains thorough knowledge of claims process systems, its databases and subsystems.
  • Responds to and resolves provider and health plan claim inquiries. Monitors and tracks aged, pended, and open reports to maintain timeliness in claims processing.Inputs claims into the system for appropriate tracking and processing.
  • Documents file, as appropriate, to support payment decision.
  • Serves as a Subject Matter Expert and conducts training as required.
  • Conducts cross training to staff as required.
  • Actively participates in user acceptance testing functions, such as test script development, testing and documentation of test results.

Education/Experience:​
  • Minimum 4 years’ experience in claims and/or call center required.
  • High School/GED required.
  • Associate  degree preferred; minimum 45 wpm typing preferred.
  • Healthcare or Managed Care experience preferred.
  • Working knowledge of PC apps in a windows based environment.

Training Information: 

  • Training is conducted onsite Monday through Friday from 8:30 AM – 5:00 PM and lasts approximately 6–8 weeks. During this period, you are required to be fully available and onsite for the entire duration of training.

  • Upon successful completion of training, the role will transition to a remote work environment. However, you may be required to report to a business office for mandatory meetings and/or technical support related to remote work.

Work Schedule: 

  • Our Contact Center operates 24 hours a day, and this position requires flexibility to work shifts between 7:00 AM – 7:00 PM. Start times will vary on a weekly basis, typically ranging from 7:00 AM to 10:30 AM, and are assigned based on business needs (example shift: 10:30 AM – 7:00 PM).

  • Your permanent schedule will be assigned toward the end of training and will remain consistent based on operational needs.

Our Comprehensive Benefits Package
Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents starting Day 1, 401(k) retirement savings plan, tuition reimbursement, and more.

Why Join Us: Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you are driven to make a difference, we want to hear from you.

About AmeriHealth Caritas
Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. Our services include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at http://www.amerihealthcaritas.com

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