Claims Examiner - Remote
Tampa, FL · Remote
Process claims end-to-end * Identify and escalate complex or unusual claims for further review or ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...
Claims Examiner - Remote
Tampa, FL · Remote
Process claims end-to-end * Identify and escalate complex or unusual claims for further review or ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...
Claims Examiner - Remote
Tampa, FL · On-site +1
Process claims end-to-end * Identify and escalate complex or unusual claims for further review or ... Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive ...
Claims Examiner - Remote
Tampa, FL · On-site +1
Process claims end-to-end * Identify and escalate complex or unusual claims for further review or ... Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive ...
Process claims end-to-end * Identify and escalate complex or unusual claims for further review or ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...
Process claims end-to-end * Identify and escalate complex or unusual claims for further review or ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...
Medical Biller/Claims Processing
Miami, FL · Remote
$23/hr
Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...
Medical Biller/Claims Processing
Miami, FL · Remote
$23/hr
Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...
Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...
Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...
Successfully complete training and demonstrate proficiency in assigned claims processes ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...
Successfully complete training and demonstrate proficiency in assigned claims processes ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...
Successfully complete training and demonstrate proficiency in assigned claims processes ... Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive ...
Successfully complete training and demonstrate proficiency in assigned claims processes ... Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive ...
Examiner, Claims Location: FL
Saint Petersburg, FL · Remote
$14 - $26.42/hr
... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing ...
Examiner, Claims Location: FL
Saint Petersburg, FL · Remote
$14 - $26.42/hr
... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing ...
Examiner, Claims Location: FL
Orlando, FL · Remote
$14 - $26.42/hr
... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing ...
Examiner, Claims Location: FL
Orlando, FL · Remote
$14 - $26.42/hr
... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing ...
Examiner, Claims Location: FL
Miami, FL · Remote
$14 - $26.42/hr
... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing ...
Examiner, Claims Location: FL
Miami, FL · Remote
$14 - $26.42/hr
... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing ...
Examiner, Claims Location: FL
Jacksonville, FL · Remote
$14 - $26.42/hr
... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing ...
Examiner, Claims Location: FL
Jacksonville, FL · Remote
$14 - $26.42/hr
... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing ...
Examiner, Claims Location: FL
Tampa, FL · Remote
$14 - $26.42/hr
... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing ...
Examiner, Claims Location: FL
Tampa, FL · Remote
$14 - $26.42/hr
... processing errors. Essential Job Duties Evaluates the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing ...
Claims Adjuster Senior
Orlando, FL · Remote
Whether you're managing claims, supporting clients, or improving processes, you'll play a vital ... This role is eligible for fully remote work. How you'll make an impact * Apply claims management ...
New
Claims Adjuster Senior
Orlando, FL · Remote
Whether you're managing claims, supporting clients, or improving processes, you'll play a vital ... This role is eligible for fully remote work. How you'll make an impact * Apply claims management ...
New
Sr. Claim Representative/Claim Consultant
Lake Mary, FL · On-site +1
$62K - $127K/yr
The Marine Claims professional is responsible for maintaining and processing Marine claims. You ... This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office ...
Sr. Claim Representative/Claim Consultant
Lake Mary, FL · On-site +1
$62K - $127K/yr
The Marine Claims professional is responsible for maintaining and processing Marine claims. You ... This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office ...
Senior Claims Adjuster Workers Compensation
Orlando, FL · Remote
$61K - $79K/yr
Location: This role is fully remote work. How you'll make an impact * Apply claims management ... Interact extensively with various parties involved in the claim process to ensure effective ...
Senior Claims Adjuster Workers Compensation
Orlando, FL · Remote
$61K - $79K/yr
Location: This role is fully remote work. How you'll make an impact * Apply claims management ... Interact extensively with various parties involved in the claim process to ensure effective ...
Workers Compensation Claims Trainee - Southeast
Orlando, FL · Remote
$60K/yr
Fully remote (candidates must physically reside in states specified although the role is remote ... claims process and build professional relationships within the organization. * Gradual Claim ...
New
Workers Compensation Claims Trainee - Southeast
Orlando, FL · Remote
$60K/yr
Fully remote (candidates must physically reside in states specified although the role is remote ... claims process and build professional relationships within the organization. * Gradual Claim ...
New
Full-Service Restoration Reviewer
Jacksonville, FL · Remote
$67K - $70K/yr
... remote Claims Force team. As a Full-Service Reviewer, you will be responsible for reviewing ... Monitor trends and performance indicators to help identify training opportunities or process ...
Full-Service Restoration Reviewer
Jacksonville, FL · Remote
$67K - $70K/yr
... remote Claims Force team. As a Full-Service Reviewer, you will be responsible for reviewing ... Monitor trends and performance indicators to help identify training opportunities or process ...
Supplemental Claims Examiner
Jacksonville, FL · On-site +1
Job Summary This role is responsible for adjudicating and processing supplemental insurance claims from intake through final payment. The position focuses on gathering and analyzing claim information ...
New
Supplemental Claims Examiner
Jacksonville, FL · On-site +1
Job Summary This role is responsible for adjudicating and processing supplemental insurance claims from intake through final payment. The position focuses on gathering and analyzing claim information ...
New
Surgical Coder - FPG Central Billing - Remote (Must be FL resident)
Sarasota, FL · Remote
$18 - $20.75/hr
... claims processing, data retrieval and analysis. Responsible for patient financial related ... Remote position. *Must be FL resident to work for Sarasota Memorial Healthcare System. *Must be ...
Surgical Coder - FPG Central Billing - Remote (Must be FL resident)
Sarasota, FL · Remote
$18 - $20.75/hr
... claims processing, data retrieval and analysis. Responsible for patient financial related ... Remote position. *Must be FL resident to work for Sarasota Memorial Healthcare System. *Must be ...
Inside Senior Property Claims Adjuster
Tampa, FL · On-site +1
USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Maintain accurate, thorough, and current claim file documentation throughout the claims process.
Inside Senior Property Claims Adjuster
Tampa, FL · On-site +1
USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Maintain accurate, thorough, and current claim file documentation throughout the claims process.
Remote Claims Processing information
What are some common challenges faced in remote claims processing roles, and how can they be effectively managed?
Remote claims processing professionals often encounter challenges such as managing high volumes of claims, maintaining clear communication with team members, and ensuring data security while working from home. Effective time management and strong organizational skills are key to handling large workloads efficiently. Regular check-ins with supervisors and using secure, company-approved communication tools can help maintain collaboration and protect sensitive information. Many organizations also provide training and support to help remote processors stay up-to-date with changing regulations and best practices.
What are the key skills and qualifications needed to thrive as a remote claims processor?
To thrive as a Remote Claims Processor, you need a strong understanding of insurance policies, attention to detail, and relevant experience or education in insurance or finance. Familiarity with claims management software, electronic document systems, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, time management, and problem-solving abilities help you stand out, especially when working independently. These skills ensure accurate, timely claims resolutions and effective collaboration with clients and colleagues in a remote environment.
What is remote claims processing?
Remote claims processing is the evaluation and handling of insurance claims by professionals who work from locations outside of a traditional office, often from home. These processors review claim submissions, verify information, assess coverage, and authorize payments or request additional information. Remote claims processors use secure online systems and communication tools to collaborate with colleagues and clients. This role requires strong attention to detail, confidentiality, and proficiency with digital platforms. Many insurance companies now offer remote claims processing positions to increase flexibility and efficiency.
What is the difference between Remote Claims Processing vs Remote Claims Adjuster?
| Aspect | Remote Claims Processing | Remote Claims Adjuster |
|---|---|---|
| Credentials | Typically requires insurance or claims processing certifications | Requires insurance licenses and adjuster certifications |
| Work Environment | Home-based, administrative setting | Home-based or field, investigative and evaluative tasks |
| Industry Usage | Insurance companies, third-party administrators | Insurance companies, public adjusting firms |
| Job Focus | Processing claims, data entry, customer service | Investigating claims, assessing damages, settlement negotiations |
Remote Claims Processing and Remote Claims Adjuster roles share similarities in industry and work environment but differ in job focus and required credentials. Claims processors handle administrative tasks and data entry, while claims adjusters evaluate damages and negotiate settlements. Both roles are essential in the insurance industry and often require specialized certifications.
What are the most commonly searched types of Claims Processing jobs in Florida? The most popular types of Claims Processing jobs in Florida are:
What are popular job titles related to Remote Claims Processing jobs in Florida? For Remote Claims Processing jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processing jobs in Florida look for? The top searched job categories for Remote Claims Processing jobs in Florida are:
- Medicaid Claims Processing Remote
- Claims Associate Three
- Urgently Hiring Remote Claims Manager
- Remote Claims
- Remote Reinsurance Claims
- Work From Home Workers Compensation Claims Assistant
- Direct Claims
- Workers Compensation Claims Manager
- Full Time International Claims Adjuster
- Long Term Disability Claims Examiner
What cities in Florida are hiring for Remote Claims Processing jobs? Cities in Florida with the most Remote Claims Processing job openings:
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 6 days ago
Job description
Claims Examiner - Remote
Job Type: Full-time
Work Setup: This is a fully remote position
Work Hours:Pacific Time Zone
We are looking forExperienced Claims Examiner to join our rapidly growing team.
Experience isrequiredfor this position.
Job Overview:
As a Claims Examiner, you will be responsible for accurately reviewing, investigating, and processing medical claims and provider dispute requests in accordance with payer guidelines, contractual agreements, regulatory requirements, and internal policies.
Responsibilities:
- Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.
- Review and investigate provider dispute requests, appeals, and reconsiderations related to processed medical claims.
- Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
- Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues.
- Participate in ongoing training and professional development activities.
- Maintain accurate and detailed records of claims processing activities.
- Review claim forms and supporting documents
- Determine eligibility, verify data accuracy
- Request additional information when needed
- Process claims end-to-end
- Identify and escalate complex or unusual claims for further review or investigation.
- Participate in ongoing training and professional development activities.
- Handle more complex claims with multiple services, providers
Experience:
- At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment.
- Experience processing Provider Dispute Resolution (PDR), appeals, reconsiderations, or claim adjustments is highly preferred.
- Understanding of health claims processing/adjudication
- Ability to perform basic to intermediate mathematical computation routines
- Medical terminology strongly preferred
- Understanding of ICD-9 & ICD-10
- Basic MS office computer skills
- Ability to work independently or within a team
- Time management skills
- Written and verbal communication skills
- Attention to detail
- Must be able to demonstrate sound decision-making skills
What We Offer
- Remote work offered
- Equipment provided
- Paid trainingto 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
Ready to Grow Your Career?
We'd love to meet you! Click"Apply Now"and tell us why you'd be a great addition to the Imagenet team.
About Imagenet, LLC
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.