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Remote Claims Processor Jobs in Irmo, SC (NOW HIRING)

Ourhrconnect

$72K - $94K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... remote. What You'll Do: * Analyze and adjudicate stop loss claims and request appropriate ... It is our policy to provide equal opportunities in all phases of the employment process and to ...

Unum UK

Associate VB Claims Specialist

Columbia, SC · Remote

$25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Ensure a timely and well communicated transfer process when transitioning integrated claims across ... Existing internal remote employees are eligible to apply. Unum and Colonial Life are part of Unum ...

CEI

RN/Managed Care Coordinator - Remote

Columbia, SC · Remote

Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare ... Performs medical or behavioral review/authorization process. Ensures coverage for appropriate ...

Amerihealth Caritas

Network Contractor PNM

Columbia, SC · On-site +1

  • Medical

  • Retirement

  • PTO

Claims processing * Payment integrity * Provider data management * Credentialing * Appeals and dispute resolution Work Arrangement:Remote; Field Based * Must reside in South Carolina. Will make ...

Ourhrconnect

Quality Medical Auditor

Columbia, SC · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

There is the potential for remote work. What You'll Do: * Determines methodology to identify cases ... Working knowledge of contract evaluations, claims processing and adjudication practices. * Required ...

TRC Talent Solutions

PAR I & II

Columbia, SC · Remote

$17 - $21.75/hr

If you thrive in a fast-paced environment, enjoy problem solving, and have experience working insurance denials and unpaid claims, we'd love to hear from you. Why Join Us? * 100% Remote * Flexible ...

CEI

Inpatient Medical Coder/Auditor

Columbia, SC · Remote

$36/hr

Remote ok, but hybrid preferred Pay: $36 /hour + optional medical, dental, vision, 401(k) match ... review processes * Ability to coordinate with claims and legal departments * Excellent report ...

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Remote Claims Processor information

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How much do remote claims processor jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for remote claims processor in Irmo, SC is $15.65, according to ZipRecruiter salary data. Most workers in this role earn between $13.37 and $16.88 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.

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The top searched job categories for Remote Claims Processor jobs in Irmo, SC are:

What cities near Irmo, SC are hiring for Remote Claims Processor jobs?

Cities near Irmo, SC with the most Remote Claims Processor job openings:

Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Irmo, SC as of August 2026, with employment types broken down into 1% Internship, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 80% Physical, 5% Hybrid, and 15% Remote job distribution, with an average salary of $32,550 per year, or $15.6 per hour.

Senior Stop Loss Claims Auditor

BlueCross BlueShield of South Carolina

Columbia, SC • On-site, Remote

$72K - $94K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted yesterday

BlueCross BlueShield of South Carolina rating

7.5

Company rating: 7.5 out of 10

Based on 69 frontline employees who took The Breakroom Quiz

224th of 310 rated insurance

Job description

Summary
Audit and authorize reimbursement of specific medical stop loss claims. Effectively mitigate client medical stop loss claims and provide excellent customer service.
Description
Position Purpose
Audit and authorize reimbursement of specific medical stop loss claims. Effectively mitigate client medical stop loss claims and provide excellent customer service.
Companion Life - one of BlueCross BlueShield's South Carolina subsidiary companies.
Location: This position is full-time (40 hours/week) Monday-Friday from 8:00am-5:00pm EST and will be fully remote.
What You'll Do:
  • Analyze and adjudicate stop loss claims and request appropriate reimbursement from carrier. Recognize cost mitigation opportunities. Authorize and release stop loss claims reimbursement checks at or below pre-set authority limits.
  • Initiate claims investigations and vendor referrals. Interpret plan language, and identify experimental services and subrogation opportunities. Identify need for follow-up on pended claims and resolution.
  • Communicate effectively with carriers, vendors, and management. Provide full claims service to both phone and written inquiries.
  • Generate and maintain claims system reports to adjust reserves, identify pending and backlog claims, and provide renewal and enrollment/premium history.
  • Develop new and review old stop loss claim forms. Assist with internal auditing of claims auditors, and training of claims auditors.

To Qualify for This Position, You'll Need the Following:
  • Required Education: Associate's
  • Degree Equivalency: 2 years of job-related work experience
  • Required Work Experience: 6 years of managed care or reinsurance claims experience.

We Prefer That You Have the Following:
  • Preferred Skills and Abilities:
  • Analyzes laws, regulations and contract language.
  • Evaluates issues and develops recommendations.
  • Handles confidential and sensitive information.
  • Investigates assigned claims.
  • Proposes claims adjustments and refunds.
  • Works claims caseloads.
  • Aggregate claims experience.

Our Comprehensive Benefits Package Includes the Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.
  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • On-site cafeterias and fitness centers in major locations
  • Education Assistance
  • Service Recognition
  • National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Pay Range Information:
Range Minimum
$49,447.00
Range Midpoint
$72,092.00
Range Maximum
$94,737.00
Pay Transparency Statement:
Please note that this range represents the pay range for this and other positions that fall into this pay grade. Compensation decisions within the range will be dependent upon a variety of factors, including experience, geographic location, and internal equity.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.
Some states have required notifications. Here's more information.

What BlueCross BlueShield of South Carolina employees say

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BlueCross BlueShield of South Carolina logo

About BlueCross BlueShield of South Carolina

Sourced by ZipRecruiter

BlueCross BlueShield of South Carolina, headquartered in Columbia, SC, USA, is a major stakeholder in the country's healthcare sector. The company holds the distinction of being one of the largest health insurers in South Carolina. As an independent licensee of the BlueCross BlueShield Association, it offers an extensive range of health insurance products and services, focusing not just on medical coverage, but also on dental, vision, and other supplementary health options. The company was founded in 1946 and has since established itself as a trusted leader in the health sector, committed to affordability, accessibility, and customer service. Their mission is to ensure that all South Carolinians have access to high-quality healthcare and exemplify the core values of accountability, transparency, and commitment to customer satisfaction.

Industry

Insurance services

Company size

10,000+ Employees

Headquarters location

Columbia, SC, US

Year founded

1946

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