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Remote Claims Processing Jobs in Tennessee (NOW HIRING)

HomeFirst Agency

Claims Adjuster I

Maryville, TN · On-site +1

Hybrid - 3 days in office, 2 days remote after training. PAY: T h e expected hiring range for this ... Maintainsworkflow to ensure timely processing of claims. * Partners withClaimsleadershipon ...

New

Corvel

Indemnity Claims Specialist

Franklin, TN · Remote

$52K - $85K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms ... process taking into consideration experience, qualifications, and overall fit for the role. The ...

Apidel Technologies

Claims Examiner - GL PL

Memphis, TN · Remote

Remote across US. FL (or any other reciprocal state) and/or NY licenses preferred. Active license ... Essential Functions and Responsibilities Analyzes and processes complex or technically difficult ...

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Remote Claims Processing information

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$10

$17

$23

How much do remote claims processing jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for remote claims processing in Tennessee is $17.39, according to ZipRecruiter salary data. Most workers in this role earn between $14.86 and $18.75 per hour, depending on experience, location, and employer.

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 popular job titles related to Remote Claims Processing jobs in Tennessee? For Remote Claims Processing jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processing jobs in Tennessee look for? The top searched job categories for Remote Claims Processing jobs in Tennessee are:
What cities in Tennessee are hiring for Remote Claims Processing jobs? Cities in Tennessee with the most Remote Claims Processing job openings:
Remote Claims Processing jobs near you
Claims Auditor- Remote

Claims Auditor- Remote

American Health Partners

Franklin, TN • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 8 days ago

Job description

American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Louisiana, Iowa, and Idaho with planned expansion into other states in 2024. For more information, visit AmHealthPlans.com.
If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application!
Benefits and Perks include:
  • Affordable Medical/Dental/Vision insurance options
  • Generous paid time-off program and paid holidays for full time staff
  • TeleMedicine 24/7/365 access to doctors
  • Optional short- and long-term disability plans
  • Employee Assistance Plan (EAP)
  • 401K retirement accounts
  • Employee Referral Bonus Program

ESSENTIAL JOB DUTIES:
To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.
  • Conduct pre-pay and post-pay audits to ensure accurate claims payments and denials
  • Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of claims processing standards
  • Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment
  • Work assigned claim projects to completion
  • Provide a high level of customer service to internal and external customers; achieve quality and productivity goals
  • Escalate appropriate claims/audit issues to management as required; follow departmental/organizational policies and procedures
  • Maintain production and quality standards as established by management
  • Participate in and support ad-hoc audits as needed
  • Other duties as assigned

JOB REQUIREMENTS:
  • Proficient in processing/auditing claims for Medicare and Medicaid plans
  • Strong knowledge of CMS requirements regarding claims processing, especially regarding skilled nursing facilities and other complex claim processing rules and regulations
  • Current experience with both Institutional and Professional claim payments
  • Knowledge of automated claims processing systems
  • Hybrid role that may require 2-3 days per week onsite at the Franklin, TN office.

REQUIRED QUALIFICATIONS:
  • Experience:
    • Two (2) years' experience with complex claims processing and/or auditing experience in the health insurance industry or medical health care delivery system
    • Two (2) years' experience in managed healthcare environment related to claims processing/audit
    • Two (2) years' experience with standard coding and reference materials used in a claim setting, such as CPT4, ICD10 and HCPCS
    • Two (2) years' experience with CMS requirements regarding claims processing; especially Skilled Nursing Facility and other complex claim processing rules and regulations
    • Two (2) years' experience processing/auditing claims for Medicare and Medicaid plans
  • License/Certification(s):
    • Coding certification preferred

EQUAL OPPORTUNITY EMPLOYER
Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.
This employer participates in E-Verify.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.
American Health Partners logo

About American Health Partners

Sourced by ZipRecruiter

American Health Partners is a family of six divisions staffed by outstanding employees who care deeply about others. Since our inception more than 45 years ago, we have been committed to bringing the highest quality healthcare available to our communities. That commitment continues to serve us, our patients, our customers and our partners well. Today, our diverse healthcare offerings serve nearly 12,000 individuals annually across multiple states. We operate in both urban and rural communities where people need healthcare close to home. By working closely with hospitals and other providers, we offer cost-effective options that give individuals greater control over their healthcare.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Franklin, TN, US

Year founded

1976

Social media

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