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Remote Claims Processor Jobs in West Virginia (NOW HIRING)

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Collaborate with cross-functional teams, including product management, finance, and claims, to ...

CSAA

$93K - $110K/yr

In order for your application to be correctly processed please sign-in before you apply Internal ... Directs cross-functional onboarding and go-live readiness across Underwriting, Actuarial, Claims ...

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... claims, and mapping their relationships across systems. As the product owner, this leader will ...

Encova Insurance

Medical Bill Adjuster

Charleston, WV · On-site +1

$43K - $70K/yr

... and process higher-dollar claims. 6. Audit high-level evaluation and management bills for ... Flexible Work Arrangements - Hybrid and remote depending on the role We believe that happy, healthy ...

Rsli

LOA Systems Specialist

Charleston, WV · Remote

$57K - $78K/yr

Assists in developing process flows for new enhancements as well as new modules as they are ... May be involved in LOA claims management for RSL and Matrix employees. * All other duties as ...

Encova Insurance

Nurse Case Manager

Charleston, WV · On-site +1

$55K - $110K/yr

However, we are open to considering candidates who can work remote in any of our listed payroll ... This role will report to a Director, Workers' Compensation Claims. Are you a Referral? If you know ...

Experian

$63K - $77K/yr

Contribute to quality and process improvement plans while maintaining current knowledge of evolving ... claims management, or adjudication. * 4+ years' knowledge of professional reimbursement ...

GDIT

Medicaid & Medicare Fraud Detection SME

WV · On-site +1

$148K - $201K/yr

Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our ... As part of the hiring process, we will ask you to complete an identity verification process that ...

GDIT

TPA core services Business Analyst

WV · On-site +1

$64K - $80K/yr

... process mapping, EDI or API integrations, eligibility and claims systems, Jira, Confluence, Azure ... Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our ...

Manulife

$93K - $110K/yr

Review contestable claims for potential misrepresentation during underwriting. * Maintain good ... process, contact hr@manulife.com. Referenced Salary Location USA, Massachusetts - Full Time Remote ...

GDIT

Healthcare Data Scientist (Medicare/Medicaid)

WV · On-site +1

$85K - $115K/yr

Assisting with the analysis of Medicare and Medicaid claims data using statistical methods and ... Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our ...

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Remote Claims Processor information

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How much do remote claims processor jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for remote claims processor in West Virginia is $14.84, according to ZipRecruiter salary data. Most workers in this role earn between $12.64 and $16.01 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 West Virginia?

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

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

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

What cities in West Virginia are hiring for Remote Claims Processor jobs?

Cities in West Virginia with the most Remote Claims Processor job openings:

Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in West Virginia as of August 2026, with employment types broken down into 88% Full Time, 9% Part Time, 1% Temporary, and 2% Contract. Highlights an 85% Physical, 4% Hybrid, and 11% Remote job distribution, with an average salary of $30,861 per year, or $14.8 per hour.

Contract Adherence Specialist

OneOncology

Charleston, WV • Remote

Full-time

Posted 13 days ago

Key responsibilities

  • Manage and maintain fee schedule related aspects of Payer Reimbursement, including securing, loading, and auditing contracted fee schedule data for accuracy.

  • Identify and resolve underpayment issues by reviewing claims, researching payment discrepancies, and managing underpayment appeals.

  • Evaluate actual reimbursement against contractual rates, perform account audits, and report recovery efforts to management.

OneOncology rating

7.9

Company rating: 7.9 out of 10

Based on 18 frontline employees who took The Breakroom Quiz

Job description

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology's mission and vision.

Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.

Job Description:

Role Summary:

The Contract Adherence Specialist will be responsible for managing and maintaining fee schedule related aspects of Payer Reimbursement, including securing, loading, and auditing contracted fee schedule data for accuracy. In addition, this position will assist in identifying and resolving underpayment related issues for all applicable payers.

Responsibilities:

  • Knowledgeable and proficient in Claims billing procedures CPT and HCPCS codes

  • Demonstrates and applies expert level of knowledge of revenue cycle processes and concepts

  • Interpret contract reimbursement

  • Maintains documentation for contractual reimbursement for payers.

  • Maintains data in appropriate database

  • Evaluates actual reimbursement compared to defined contractual reimbursement rates for specific drugs/procedures.

  • Performs account audits

  • Manages payer log spreadsheets to be submitted to the health plans.

  • Identify trends in underpayments

  • Research and identify payment discrepancies from various sources

  • Performs reviews and assessments for underpaid claims

  • Compile and analyze data for recovery

  • Manage underpayment appeals and account follow-up

  • Resolve underpaid claims in an effective and timely fashion

  • Reports dollars and recovery efforts routinely to management

  • Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer.

Required Qualifications:

High School diploma or equivalent required.
Minimum five (5) years' experience in accounts receivable, healthcare, or managed care preferred.

Essential Competencies:

  • Attendance is an essential job function.

  • Detailed knowledge of billing, HCPCS, CPT and ICD codes. Previous collections experience preferred

  • Exceptional Multi-tasking, organizational skills and attention to detail

  • Works well under deadlines and time sensitive projects while maintaining accuracy

  • Strong numeric and analytical skills

  • Self-motivated, able to work autonomously, multi-task and switch focus quickly

  • Excellent verbal and written communication skills

  • Strong knowledge of Windows-based software applications (E.g. Word, Excel, Outlook, Access)

  • Must possess high degree of professionalism and adaptability.

The above job description is a general overview of the responsibilities and competencies for this role at OneOncology. Specific details may vary based on the needs of the organization.

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