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Remote Claims Processing Jobs in Florida (NOW HIRING)

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 training to set you up for success * Comprehensive ...

Remote Reports to: Claims Supervisor Position Summary: TheClaims Quality Auditor plays a key role ... Perform detailed audits of denied, underpaid, and processed claims using EZCap to assess accuracy ...

Remote Reports to: Claims Supervisor Position Summary: The Claims Quality Auditor plays a key role ... Perform detailed audits of denied, underpaid, and processed claims using EZCap to assess accuracy ...

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 ...

Oversee day-to-day medical claims processing for professional, facility, adjustments, corrected and ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...

Mechanical Claims Analyst

Deerfield Beach, FL ยท On-site +1

$26 - $36/hr

... remote environment while maintaining a strong connection to the automotive industry. Key Responsibilities * Evaluate, investigate, and process mechanical claims accurately using established ...

Medical Billing Specialist (Remote)

Vero Beach, FL ยท Remote

$16.50 - $21.25/hr

Medical Billing Specialist (Remote) The Medical Billing Specialist is responsible for performing ... Demonstrates comprehensive ability and knowledge of electronic claims processing, electronic ...

... 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 ...

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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, and why are they important?

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?

AspectRemote Claims ProcessingRemote Claims Adjuster
CredentialsTypically requires insurance or claims processing certificationsRequires insurance licenses and adjuster certifications
Work EnvironmentHome-based, administrative settingHome-based or field, investigative and evaluative tasks
Industry UsageInsurance companies, third-party administratorsInsurance companies, public adjusting firms
Job FocusProcessing claims, data entry, customer serviceInvestigating 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 cities in Florida are hiring for Remote Claims Processing jobs? Cities in Florida with the most Remote Claims Processing job openings:
Infographic showing various Remote Claims Processing job openings in Florida as of July 2026, with employment types broken down into 86% Full Time, 8% Part Time, 2% Temporary, and 4% Contract. Highlights an 100% Remote job distribution.
Claims Examiner - Remote

Claims Examiner - Remote

Imagenet

Tampa, FL โ€ข Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 16 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.