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Remote Claims Processor Jobs in Puerto Rico (NOW HIRING)

Deloitte

Hospital Billing Operator

San Juan, PR · Remote

$18 - $23/hr

As an Epic Hospital Billing Analyst, you will help review and submit hospital claims, resolve billing issues, and work across teams to reduce avoidable denials. This is a primarily remote role ...

UnitedHealth Group

$16.75 - $21.50/hr

Review and research insurance follow-up, and denied claims by navigating multiple systems simultaneously, such as payer portals, to accurately capture data/information for accurate processing

OncoHealth

Case Review Representative

Guaynabo, PR · On-site +1

$13 - $15/hr

Triage request/claims processing issues to health plans as needed Prior authorization creation ... Remote/hybrid work experience preferred * A minimum of 2 years of healthcare related administrative ...

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Remote Claims Processor information

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 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 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 Puerto Rico? For Remote Claims Processor jobs in Puerto Rico, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Puerto Rico look for? The top searched job categories for Remote Claims Processor jobs in Puerto Rico are:
What cities in Puerto Rico are hiring for Remote Claims Processor jobs? Cities in Puerto Rico with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Puerto Rico as of July 2026, with employment types broken down into 89% Full Time, 9% Part Time, and 2% Contract. Highlights an 88% Physical, 4% Hybrid, and 8% Remote job distribution.
Multi-Line Adjuster - Inside

Multi-Line Adjuster - Inside

Crawford and Company

Guaynabo, PR • On-site, Remote

Full-time

Posted 11 days ago

Job description

?? Ready to Lead with Expertise?
?? Be the Adjuster Who Makes a Difference!
Join Us as Multi-Line Adjuster - Remote/Hybrid Role | Guaynabo, PR

What's in it for you?

?? Competitive Pay
?? Flexibility: Remote work allowed in any state, but preference for candidates in Puerto Rico.
?? Impactful Work: Help restore lives and communities through expert claims handling.
At Crawford, every claim represents a person and a community we help rebuild. As a Multi-Line Adjuster, your experience and bilingual skills will ensure accurate, timely resolutions and exceptional client service.

Ready to make an impact through expertise and care? Apply today and join the One Crawford family!

  • College degree or an equivalent combination of education and experience.
  • Minimum 2 years insurance adjusting experience with experience in each of at least two lines of business (casualty, property, or marine).
  • Personal computer, typing and keyboarding skills
  • In-depth knowledge of insurance coverage, practices and negotiating skills in multiple lines of business.
  • Familiarity with legal, medical and technical disciplines within specific business lines.
  • Strong verbal and written communication skills.
  • Good analytical ability and mathematical aptitude.
  • Good attention to detail and organizational skills.
  • Ability to gather and analyze information, then determine and implement the appropriate course of action.
  • Good interpersonal skills.
  • Licensing as required by state and local jurisdictions.
  • Additional continuing education as required by Crawford Educational Services and as applicable for jurisdictions in which claims are adjusted or investigated.
  • College degree or an equivalent combination of education and experience.
  • Minimum 2 years insurance adjusting experience with experience in each of at least two lines of business (casualty, property, or marine).
  • Personal computer, typing and keyboarding skills
  • In-depth knowledge of insurance coverage, practices and negotiating skills in multiple lines of business.
  • Familiarity with legal, medical and technical disciplines within specific business lines.
  • Strong verbal and written communication skills.
  • Good analytical ability and mathematical aptitude.
  • Good attention to detail and organizational skills.
  • Ability to gather and analyze information, then determine and implement the appropriate course of action.
  • Good interpersonal skills.
  • Licensing as required by state and local jurisdictions.
  • Additional continuing education as required by Crawford Educational Services and as applicable for jurisdictions in which claims are adjusted or investigated.

#LI-CB3

  • Investigate coverage, liability, and damages with all parties involved in a claim as requested by our customers or Crawford and Company or a subsidiary thereof.
  • Investigate claims by interviewing claimants, witnesses, establish claim reserves, handle evidence, obtain and interpret official reports, medical reports and claim forms, and attend/participate at mediation, trials or hearings.
  • Negotiates and settles claims, sets reserves, and manages litigation within client service parameters and authority levels by obtaining demands and making offers to claimants.
  • May present evidence at legal proceedings.
  • Provide filings with regulatory agencies, disposing of salvage and pursuing subrogation when appropriate.
  • Prepare reports by collecting and summarizing information required by the client and obtained through investigation.
  • Self starter capable of working alone or with others.
  • Maintains company reputation and insurance product integrity by complying with Federal and state regulations, client and Crawford and Company service standards.
  • Maintain expected case loads in multiple lines of business while meeting established service delivery, production, quality, sales and educational objectives.
  • May be required to work on-call during off work hours to respond to emergency on-site investigations.
  • Maintain professional and technical knowledge through continuing education in multiple lines of business.
  • Maintain acceptable product quality through compliance with service standards and compliance with internal quality control initiatives.
  • Uphold and project the corporate image by participating in industry organizations and functions.
  • Ability to multi-task in a time sensitive environment and handle job responsibilities with a sense of urgency.
  • Participates in special projects or performs duties in other areas as requested.
  • Upholds the Crawford Code of Conduct.

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