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Remote Claims Processor From Home Jobs in Florida

Imagenet

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 ...

Imagenet

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 ...

Imagenet

Claims Examiner - Remote (Alameda)

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 ...

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Symmetry

Remote Sales, Work From Home

Tampa, FL · Remote

Remote Sales / Work From Home Must be authorized to work in the US, no work visas offered at this time Organization Description: We are looking for Sales Representatives who want to take charge of ...

Bosun

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 ...

Symmetry

Remote Sales Work From Home

Jacksonville, FL · Remote

Insurance Producer - 100% Remote Must be authorized to work in the US, no work visas offered at this time Organization Description: Robinson Insurance Agency focuses on protecting families with life ...

The Semler Agency

Work From Home Sales

Jacksonville, FL · On-site +1

We are currently hiring for a remote sales position with a structured training program . This role ... Follow a simple, structured process What You'll Get: * Guided training program * Support from ...

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Remote Claims Processor From Home information

What are the key skills and qualifications needed to thrive as a remote claims processor from home, and why are they important?

To thrive as a Remote Claims Processor From Home, you need strong attention to detail, analytical abilities, and knowledge of insurance policies, typically supported by a high school diploma or equivalent and relevant work experience. Familiarity with claims management software, document management systems, and secure communication tools is essential. Excellent time management, self-motivation, and clear written communication are standout soft skills for working independently. These competencies ensure accurate, efficient claim handling and maintain customer satisfaction in a remote environment.

What are some common challenges faced by remote claims processors from home, and how can they be managed effectively?

Remote claims processors often encounter challenges such as managing high volumes of claims, maintaining clear communication with team members, and ensuring data security while working from home. Staying organized with digital tools, setting a structured daily routine, and actively participating in virtual team meetings can help address these issues. Additionally, leveraging secure company-approved platforms for document sharing and adhering to privacy protocols are essential for protecting sensitive client information.

What does a remote claims processor from home do?

A Remote Claims Processor from home is responsible for reviewing, evaluating, and processing insurance claims submitted by policyholders. They work from their home office, handling documentation, verifying information, and ensuring claims are accurate and comply with company policies. The role often involves data entry, communication with clients and insurance agents, and using specialized software. Working remotely, claims processors must be detail-oriented and able to manage their workload independently. This job is common in the health, auto, and property insurance industries.

What is the difference between Remote Claims Processor From Home vs Remote Claims Processor From Office?

AspectRemote Claims Processor From HomeRemote Claims Processor From Office
Work EnvironmentHome-based, flexible scheduleOffice-based, fixed hours
CredentialsSimilar certifications, such as claims processing or insurance licensesSame credentials required
Employer & IndustryInsurance companies, healthcare providersSame industry, different setting
Search & ComparisonCommonly compared for remote work optionsLess frequently searched as a comparison

The main difference between Remote Claims Processor From Home and Remote Claims Processor From Office is the work environment. The remote role offers flexibility and a home-based setting, while the office-based position requires working on-site. Credentials and industry usage are similar, making the choice primarily about work location preferences.

What are the most commonly searched types of Remote Claims Processor jobs in Florida? The most popular types of Remote Claims Processor jobs in Florida are:
What cities in Florida are hiring for Remote Claims Processor From Home jobs? Cities in Florida with the most Remote Claims Processor From Home job openings:
Remote Claims Processor From Home jobs near you

Claims Examiner - Remote

Imagenet

Tampa, FL • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 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.

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