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Remote Claims Processor Jobs in Missouri (NOW HIRING)

Missouri Employers Mutual

$72K - $109K/yr

You'll be a key decision-maker, a mentor to junior adjusters, and a champion of process improvement ... Claims Handling & Administration * Manage highly complex claims involving significant financial ...

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How much do remote claims processor jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for remote claims processor in Missouri is $17.98, according to ZipRecruiter salary data. Most workers in this role earn between $15.34 and $19.38 per hour, depending on experience, location, and employer.

What does a remote claims processor do?

The job duties of a remote claims processor revolve around working to process insurance claims. You typically work from home or another remote location. Your responsibilities start with assessing the claimant's insurance policy and coverage. You review documents and records related to the claim and decide on approval or denial of the claim. A processor also prepares the paperwork necessary for the insurer to process the case for the client. You also have customer service duties, such as answering patient questions and telling them about the claim status. Processors can work with medical insurance, property insurance, or casualty insurance.

What does a remote claims processor do?

A Remote Claims Processor reviews, evaluates, and processes insurance claims from a remote location, typically working from home. They verify information, assess documentation, and determine the validity of claims for insurance companies or healthcare providers. This role requires attention to detail, knowledge of insurance policies, and the ability to communicate with clients or providers to resolve discrepancies. Remote Claims Processors use specialized software to manage claims efficiently and ensure compliance with industry regulations.

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 strong attention to detail, analytical skills, and a solid understanding of insurance policies, often supported by a high school diploma or relevant experience. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent written communication, time management, and problem-solving abilities help you stand out in this role. These skills ensure accurate and efficient claims handling, customer satisfaction, and compliance with regulatory standards in a remote work environment.

What are some common challenges faced by remote claims processors, and how can they be addressed?

Remote Claims Processors often encounter challenges such as managing high volumes of claims, maintaining accuracy without in-person supervision, and communicating effectively with team members across different locations. To address these, it's essential to develop strong organizational skills, utilize digital tools for tracking and documentation, and participate actively in virtual team meetings. Proactively seeking feedback and staying updated on policy changes can also enhance efficiency and reduce errors in a remote setting.

What is the difference between Remote Claims Processor vs Remote Claims Examiner?

AspectRemote Claims ProcessorRemote Claims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance or claims processing certificationsHigh school diploma or equivalent; often requires licensing or certification in insurance claims examination
Work EnvironmentHome-based or remote office; primarily computer and phone workHome-based or remote; involves reviewing and analyzing insurance claims
Industry UsageInsurance, healthcare, government agenciesInsurance companies, healthcare providers, government agencies
Common Search/ComparisonYesYes

Remote Claims Processors and Remote Claims Examiners both work in the insurance industry, often remotely, handling claims. While both roles require similar credentials and work environments, Claims Examiners typically perform more detailed analysis and may require specific licensing. Understanding these differences helps job seekers identify the right position based on their skills and certifications.

More about Remote Claims Processor jobs

What are popular job titles related to Remote Claims Processor jobs in Missouri?

For Remote Claims Processor jobs in Missouri, the most frequently searched job titles are:

What job categories do people searching Remote Claims Processor jobs in Missouri look for?

The top searched job categories for Remote Claims Processor jobs in Missouri are:

What cities in Missouri are hiring for Remote Claims Processor jobs?

Cities in Missouri with the most Remote Claims Processor job openings:

Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Missouri as of August 2026, with employment types broken down into 1% Internship, 84% Full Time, 12% Part Time, and 3% Contract. Highlights an 81% Physical, 5% Hybrid, and 14% Remote job distribution, with an average salary of $37,392 per year, or $18 per hour.

Pharmacy Claims Audit Supervisor - Remote US

Gainwell Technologies LLC

MO • Remote

$47K - $67K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago

Gainwell Technologies rating

7.8

Company rating: 7.8 out of 10

Based on 83 frontline employees who took The Breakroom Quiz

138th of 247 rated software companies

Job description

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

Supervises claims audit operations within Pharmacy Benefit Management (PBM) services. Ensures accurate adjudication of pharmacy claims while maintaining compliance with Medicaid requirements and operational performance standards.  The Claims Audit Supervisor will have oversight of all FWA Audit Services including Concurrent Claims Review, Desk Audit and Field Audit.

Your role in our mission
  • Lead and develop a team responsible for drug claims auditing and adjudication activities
  • Oversee claim audit workflows to ensure accuracy, timeliness, and compliance with PBM and Medicaid guidelines
  • Monitor performance metrics (productivity, quality, turnaround times) and implement process improvements to identify discrepancies.
  • Manage escalations and resolve complex claims issues involving members, providers, and pharmacies
  • Partner with internal teams to support system updates, audits, and ongoing claims operations
  • Work with state to present audit findings, develop new capabilities and manage appeal processes
What we're looking for
  • Must hold an active Pharmacy Technician certificatioin (CPhT), such as PTCB.
  • 5+ years of PBM, pharmacy operations, drug claims processing and audit operations experience
  • 2+ years of leadership or supervisory experience
  • Strong knowledge of identifying drug claim anomalies and pharmacy audit operations
  • Strong knowledge of pharmacy claims adjudication and Medicaid programs
  • Experience with client communications and leading discussions with clients
  • Experience with operational reporting, KPIs, and process improvement
What you should expect in this role
  • This is a remote work from home position.
  • Leadership within a high-volume audit processing environment
  • Collaboration with pharmacy, clinical, clients and IT teams
  • Focus on accuracy, compliance, and operational efficiency
  • Access to Gainwell’s competitive benefits package for eligible employees, including medical, dental, vision, and 401(k) options in accordance with applicable eligibility guidelines.

#LI-REMOTE

#LI-JT1

#LI-CM1

The pay range for this position is $47,300.00 - $67,600.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

What Gainwell Technologies employees say

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Hours and flexibility

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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