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Remote Claims Manager Jobs in Reston, VA (NOW HIRING)

Ourhrconnect

Auditor, Sr Stoploss Claim

Alexandria, VA · On-site +1

$74K - $97K/yr

... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ... Communicate effectively with carriers, vendors, and management. Provide full claims service to both ...

WearLinq

Medical Billing Associate

Rockville, MD · Remote

Key Responsibilities Billing & Claims Management * Prepare, review, and submit professional and ... Benefits: * Optional Remote work opportunity * 401(k) * Dental insurance * Health insurance

Colliers

Litigation Paralegal

Washington, DC · Remote

$28 - $33.65/hr

This is a remote position based out of our various work states listed on the posting.*** About the ... Manage and respond to subpoenas, garnishment orders, discovery requests, and other legally mandated ...

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Remote Claims Manager information

See Reston, VA salary details

$36.4K

$91.4K

$144.6K

How much do remote claims manager jobs pay per year?

As of Jun 12, 2026, the average yearly pay for remote claims manager in Reston, VA is $91,407.00, according to ZipRecruiter salary data. Most workers in this role earn between $70,700.00 and $109,200.00 per year, depending on experience, location, and employer.

What is a Remote Claims Manager job?

A Remote Claims Manager oversees the processing, evaluation, and resolution of insurance claims while working from a remote location. They ensure claims are handled efficiently, fairly, and in compliance with company policies and regulations. Responsibilities typically include supervising claims adjusters, reviewing complex cases, and improving claims handling processes. Strong analytical skills, attention to detail, and the ability to manage a remote team are essential for this role.

What are some common challenges faced by Remote Claims Managers, and how can they be addressed?

Remote Claims Managers often face challenges such as maintaining efficient communication with team members and clients, managing a high volume of claims, and ensuring compliance with regulatory guidelines across multiple jurisdictions. Overcoming these challenges requires strong organizational skills, use of collaborative digital tools, and a proactive approach to problem-solving. Staying up to date with industry best practices and participating in regular training can also help remote claims managers remain effective and adapt to changing requirements. By establishing clear workflows and leveraging technology, you can ensure successful outcomes and support your team's performance, even in a virtual environment.

What are the key skills and qualifications needed to thrive in the Remote Claims Manager position, and why are they important?

To excel as a Remote Claims Manager, you need strong analytical abilities, comprehensive knowledge of claims processes, and typically a relevant degree or substantial experience in insurance or claims management. Familiarity with claims management systems, CRM software, and relevant certifications like CPCU or AIC is valuable. Excellent communication, decision-making, and organizational skills help set outstanding candidates apart in this role. These qualifications ensure efficient claims handling, regulatory compliance, and effective remote team leadership.

What are the most commonly searched types of Remote Claims jobs in Reston, VA? The most popular types of Remote Claims jobs in Reston, VA are:
What are popular job titles related to Remote Claims Manager jobs in Reston, VA? For Remote Claims Manager jobs in Reston, VA, the most frequently searched job titles are:
What job categories do people searching Remote Claims Manager jobs in Reston, VA look for? The top searched job categories for Remote Claims Manager jobs in Reston, VA are:
What cities near Reston, VA are hiring for Remote Claims Manager jobs? Cities near Reston, VA with the most Remote Claims Manager job openings:
Remote Claims Manager jobs near you

Auditor, Sr Stoploss Claim

Ourhrconnect

Alexandria, VA • On-site, Remote

$74K - $97K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 27 days ago

Job description


Summary
 Audit and authorize reimbursement of specific medical stop loss claims. Effectively mitigate client medical stop loss claims and provide excellent customer service.
Description
 

Position Purpose:

Audit and authorize reimbursement of specific medical stop loss claims. Effectively mitigate client medical stop loss claims and provide excellent customer service.

Logistics:PACE Underwriters-one of BlueCross BlueShield's South Carolina subsidiary companies.

Location:This position is full-time (40 hours/week) Monday-Friday from8:00am-4:30pm CSTand will befully remote or hybridif based near our Dallas office.

What You'll Do:

  • Analyze and adjudicate stop loss claims and request appropriate reimbursement from carrier. Recognize cost mitigation opportunities. Authorize and release stop loss claims reimbursement checks at or below pre-set authority limits.

  • Initiate claims investigations and vendor referrals. Interpret plan language, and identify experimental services and subrogation opportunities. Identify need for follow-up on pended claims and resolution.

  • Communicate effectively with carriers, vendors, and management. Provide full claims service to both phone and written inquiries.

  • Generate and maintain claims system reports to adjust reserves, identify pending and backlog claims, and provide renewal and enrollment/premium history.

  • Develop new and review old stop loss claim forms. Assist with internal auditing of claims auditors, and training of claims auditors.

To Qualify for This Position, You'll Need the Following:

  • Required Education:Associate's

  • Required Work Experience:6 years of managed care or reinsurance claims experience.

We Prefer That You Have the Following:

  • Preferred Skills and Abilities:

  • Analyzes laws, regulations and contract language.

  • Evaluates issues and develops recommendations.

  • Handles confidential and sensitive information.

  • Investigates assigned claims.

  • Proposes claims adjustments and refunds.

  • Works claims caseloads.

  • Aggregate claims experience.

Our Comprehensive Benefits Package Includes the Following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.

  • Subsidized health plans, dental and vision coverage

  • 401k retirement savings plan with company match

  • Life Insurance

  • Paid Time Off (PTO)

  • On-site cafeterias and fitness centers in major locations

  • Education Assistance

  • Service Recognition

  • National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What To Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Pay Range Information:

Range Minimum

$51,107.00

Range Midpoint

$74,418.00

Range Maximum

$97,729.00

Pay Transparency Statement:

Please note that this range represents the pay range for this and other positions that fall into this pay grade. Compensation decisions within the range will be dependent upon a variety of factors, including experience, geographic location, and internal equity.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.

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