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Remote Claims Processor Jobs in Appleton, WI (NOW HIRING)

ThedaCare

Accounts Receivable Specialist - Remote

Neenah, WI · On-site +1

$20.75 - $27.50/hr

Processes claims in a timely manner according to contracts, regulations, department standards, and form requirements. * Generates phone calls to all parties to check status of unprocessed, unpaid, or ...

Bellin

Biller | Patient Financial Services

Green Bay, WI · On-site +1

$17.75 - $22.75/hr

Job Specifics Location: 2020 S Webster Ave, Green Bay, WI 54301, can be remote after training FTE ... Ensures all paper and electronic claims are submitted in a timely and accurate manner in compliance ...

Winlandfoods

Accounts Payable Specialist

Green Bay, WI · On-site +1

$24.52 - $41.82/hr

Remote Monday and Friday; In office Tuesday to Thursday Work Location: 1120 Employers Blvd, De Pere ... to the GRIR processes. * Perform monthly reconciliation of vendor credit memos and claims and ...

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Remote Claims Processor information

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$11

$18

$25

How much do remote claims processor jobs pay per hour?

As of May 31, 2026, the average hourly pay for remote claims processor in Appleton, WI is $18.69, according to ZipRecruiter salary data. Most workers in this role earn between $15.96 and $20.14 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 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 Appleton, WI? For Remote Claims Processor jobs in Appleton, WI, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Appleton, WI look for? The top searched job categories for Remote Claims Processor jobs in Appleton, WI are:
What cities near Appleton, WI are hiring for Remote Claims Processor jobs? Cities near Appleton, WI with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Appleton, WI as of May 2026, with employment types broken down into 34% Full Time, 63% Part Time, and 3% Contract. Highlights an 81% Physical, 5% Hybrid, and 14% Remote job distribution, with an average salary of $38,878 per year, or $18.7 per hour.

Family Savings Plan Claims Analyst

Network Health

Menasha, WI • On-site, Remote

Full-time

Posted 11 days ago

Job description

The Family Savings Plan (FSP) Claims Analyst is responsible for the accurate and timely entry, processing, adjudication, and auditing of medical and pharmacy claims. This role supports end-to-end claims operations and ensures compliance with established policies, procedures, contractual requirements, and regulatory guidelines while contributing to operational excellence and service quality.
Key responsibilities include high-volume data entry of medical and pharmacy claims, detailed claims review and adjudication, quality audits, and participation in training and continuous improvement initiatives. The analyst plays a critical role in maintaining data integrity, identifying discrepancies, and ensuring accuracy and consistency across claims systems and processes.
This position requires strong collaboration with cross-functional stakeholders across multiple levels of the organization to support strategic objectives, operational efficiencies, and service excellence. The FSP Claims Analyst may also assist with benefit interpretation, in-depth review and analysis of medical and pharmacy claims, and comprehensive claims research to resolve complex issues, discrepancies, or inquiries.
Additionally, the individual is expected to effectively communicate findings and recommendations, demonstrate strong analytical and problem-solving abilities, and handle confidential and sensitive information with professionalism and discretion. A commitment to accuracy, productivity, accountability, and customer-focused service is essential in supporting organizational priorities and delivering high-quality claims management outcomes.
Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model. Travel to the office in Menasha or Brookfield will be required occasionally for the position, including on first day.
Hours: 1.0 FTE, 40 hours per week, 8am-5pm Monday through Friday
Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.
Job Responsibilities:

    • Perform accurate and timely data entry of member- and provider-submitted medical and pharmacy claims.
    • Process medical and pharmacy claims in accordance with established policies, procedures, contractual requirements, and regulatory guidelines.
    • Audit claims to ensure accuracy in data entry, coding, and payment, identifying and correcting discrepancies as needed.
    • Demonstrate behaviors consistent with Network Health’s mission, vision, values, and organizational philosophy.
    • Respond to internal inquiries regarding claim status, issues, and benefit interpretation within established turnaround times (typically within 24 hours) to meet departmental metrics and contractual standards.
    • Proactively follow up with internal departments to resolve outstanding issues or concerns, and appropriately escalate complex or unresolved matters to a Supervisor or designated contact.
    • Maintain strong attention to detail, accuracy, and productivity standards while handling sensitive and confidential information.
    • Perform additional duties and responsibilities as assigned to support departmental and organizational goals.

    Job Requirements:

      • HS Diploma required, associate degree preferred
      • 2+ Years working in the health insurance industry preferred
      • Data entry, medical and pharmacy claims processing experience strongly preferred
      • Medical terminology experience preferred


      Network Health is an Equal Opportunity Employer

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