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

Bcbsa

Financial Audit Senior Consultant

Columbia, SC · Remote

$107K/yr

... the audit process; instruct audit flow facilitation; analyze and assess audit trends, best ... Intermediate knowledge of auditing, finance, and claims operations. * Advanced negotiation ...

New

Afni, Inc.

Remote Customer Service Representative

SC · On-site +1

$14.75 - $20/hr

Those calls will require processing of orders, updating accounts, updating records, effective ... Wisconsin * Iowa What You Need to Thrive in Our Remote Environment: * Cable or Fiber Internet ...

Absolute Total Care

Medical Director

Columbia, SC · On-site +1

$225K - $428K/yr

... processes, and membership. * Conduct regular rounds to assess and coordinate care for high-risk ... Reviews claims involving complex, controversial, or unusual or new services in order to determine ...

Absolute Total Care

Medical Director

Columbia, SC · On-site +1

$225K - $428K/yr

... processes, and membership. * Conduct regular rounds to assess and coordinate care for high-risk ... Reviews claims involving complex, controversial, or unusual or new services in order to determine ...

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Showing results 21-40

All JobsClaims Processor JobsRemote Claims Processor JobsRemote Claims Processor Jobs in Lexington, SC

Remote Claims Processor information

See Lexington, SC salary details

$10

$16

$22

How much do remote claims processor jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for remote claims processor in Lexington, SC is $16.40, according to ZipRecruiter salary data. Most workers in this role earn between $13.99 and $17.69 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 Lexington, SC? For Remote Claims Processor jobs in Lexington, SC, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Lexington, SC look for? The top searched job categories for Remote Claims Processor jobs in Lexington, SC are:
What cities near Lexington, SC are hiring for Remote Claims Processor jobs? Cities near Lexington, SC with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Lexington, SC as of July 2026, with employment types broken down into 86% Full Time, 12% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $34,121 per year, or $16.4 per hour.

Customer Service Supervisor PBM

Marpai Administrators LLC

Columbia, SC • Remote

$58K - $65K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

Job description


Marpai Administrators (Subsidiary of Marpai Inc. (NASDAQ: MRAI)) is a technology company transforming the Third Party Administration sector serving employers with self-funded health plans. Marpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. We create healthier members and a healthier bottom line. Marpai proactively targets at-risk members with meaningful clinical interventions to improve outcomes. 
 
ABOUT THE POSITION: 
 
The Customer Service Supervisor, PBM reports to the Customer Service Manager and is responsible for leading a team of specialized agents, customer service representatives, to deliver high-quality service to resolve complex questions regarding prescription drug coverage. This role plays a critical part in enhancing customer satisfaction, driving retention, and supporting the overall business objectives by maintaining efficient operations and fostering a positive team environment. 
 
WHAT YOU WILL BE DOING: 
 
  • Supervise team: Guide the team through complex member inquiries regarding drug formularies, tier structures, and copays. Supervise the investigation and resolution with members, pharmacies and prescribers of rejected pharmacy claims, coordinating eligibility overrides and technical point-of-sale errors. 
  • Enforce compliance with regulatory requirements: Monitor and train teams on strict adherence to HIPAA regulations and other applicable regulations.
  • Monitor Key Performance Indicators (KPI) and Service Level Agreements (SLA): Ensure the team meets contractual SLAs. 
  • Training and Coaching: Analyze trends of issues to identify, training gaps, performance issues, and create a plan to address the gaps and recommend solutions as needed. Provide coaching and critical conversations to direct reports for developmental and correctional issues. 
  • Quality assurance and audits: Complete monthly call monitoring. Review monthly scorecard with individuals on team, identifying trends that need to be addressed as well as kudos for jobs well done.
  • Handles overflow for calls, chat, and emails as needed especially during peak
  • Maintain and develop Standard Operating Procedures
  • Other duties as required
 
WHAT SUCCESS LOOKS LIKE: 
 
  • Drive member accessibility through effectively managing resources, coordinating multiple daily tasks, and enhancing the effectiveness of customer interactions
  • Ensure exceptional quality through the monitoring and coaching of call interactions and claim processing
  • Cultivate the ultimate customer experience by ensuring the team is well trained and coached
  • Ensure team is meeting and exceeding expectations and metrics
 
WHAT DO YOU NEED:
  • Industry Experience: 2+ years of experience in a PBM, managed care, healthcare call center, or pharmacy environment.
  • Preferred License: Active Certified Pharmacy Technician (CPhT) designation or state pharmacy technician license is highly preferred. 
  • 3 years minimum call center experience
  • 3+ years in a supervisory or leadership role in a call center
  • Strong leadership and team management skills
  • Excellent communication, both verbal and written
  • Problem-solving and conflict resolution skills
  • Ability to analyze performance metrics and use data to improve team effectiveness
  • Encourage and support accountability and engagement, including sharing of information, ownership and successes with others
  • Consistently communicate expectations to clients and internal team members
  • Capability to manage service recovery as necessary

WORK REQUIREMENTS:
  • Tampa, FL or Remote
  • Fast paced, dynamic work environment requiring the ability to be adaptive, innovative and flexible
  • No travel required 
 
 WHY WORK AT MARPAI?  
We have great benefits: 
  • Generous PTO
  • Medical and Prescription 
  • Health and Wellness Programs 
  • EAP 
  • FSA / HSA / Dependent Care
  • Dental 
  • Vision 
  • Life and Disability 
  • STD/LTD
  • Voluntary Benefits: Critical Illness, Accident, Hospital
  • 401k with Employer Match
  • LegalShield 
  • Identity Theft Protection
       
    Marpai is an equal opportunity workplace.  We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.
     
     

This is a remote position.