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Remote Claims Processor Jobs in Tennessee (NOW HIRING)

HomeFirst Agency

Claims Adjuster

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 ...

MEM

Senior Claims Representative (Remote)

Columbia, TN · On-site +1

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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Remote Claims Processor information

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$10

$17

$23

How much do remote claims processor jobs pay per hour?

As of Aug 3, 2026, the average hourly pay for remote claims processor 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 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 Tennessee? For Remote Claims Processor jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Tennessee look for? The top searched job categories for Remote Claims Processor jobs in Tennessee are:
What cities in Tennessee are hiring for Remote Claims Processor jobs? Cities in Tennessee with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Tennessee as of July 2026, with employment types broken down into 86% Full Time, 11% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $36,181 per year, or $17.4 per hour.

Claims Auditor- Remote

American Health Partners

Franklin, TN • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 26 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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