Manager, Claims
Marshfield, WI · Remote
The process includes the review and/or testing of claims, benefits and fee schedules to ensure claims process correctly. Accountable as a resource to all employees in the claims department as well as ...
Marshfield, WI · Remote
The process includes the review and/or testing of claims, benefits and fee schedules to ensure claims process correctly. Accountable as a resource to all employees in the claims department as well as ...
Marshfield, WI · Remote
The process includes the review and/or testing of claims, benefits and fee schedules to ensure claims process correctly. Accountable as a resource to all employees in the claims department as well as ...
$12.02 - $13.33
2% of jobs
$13.33 - $14.64
6% of jobs
$14.64 - $15.95
9% of jobs
$16.63 is the 25th percentile. Wages below this are outliers.
$15.95 - $17.26
14% of jobs
$17.26 - $18.57
18% of jobs
The median wage is $18.61 / hr.
$18.57 - $19.88
17% of jobs
$20.61 is the 75th percentile. Wages above this are outliers.
$19.88 - $21.20
16% of jobs
$21.20 - $22.51
7% of jobs
$22.51 - $23.82
4% of jobs
$23.82 - $25.13
4% of jobs
$25.13 - $26.44
2% of jobs
$12
$19
$26
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.
| Aspect | Remote Claims Processor | Remote Claims Examiner |
|---|---|---|
| Required Credentials | High school diploma or equivalent; some roles may require insurance or claims processing certifications | High school diploma or equivalent; often requires licensing or certification in insurance claims examination |
| Work Environment | Home-based or remote office; primarily computer and phone work | Home-based or remote; involves reviewing and analyzing insurance claims |
| Industry Usage | Insurance, healthcare, government agencies | Insurance companies, healthcare providers, government agencies |
| Common Search/Comparison | Yes | Yes |
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.

6.8
Based on 538 frontline employees who took The Breakroom Quiz
494th of 890 rated healthcare providers
Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland.
Work Shift:
8 Hours - Day Shifts (United States of America)Scheduled Weekly Hours:
40Compensation:
Union Position:
NoDepartment Details
This position allows some work from home options as well as a flexible scheduleSummary
The Claims Manager is under the general supervision of the Sanford Health Plan Director of Claims, in the areas of health insurance claims submitted by providers and patients for processing.Job Description
Responsible for the implementation and day-to-day performance of process activities related to claims research and resolution. The process includes the review and/or testing of claims, benefits and fee schedules to ensure claims process correctly. Accountable as a resource to all employees in the claims department as well as other departments in the organization. Responsible for the interviewing, hiring, discipline of employees and any other personnel issues that arise. Completes performance appraisals. Coordinates claims processing and adjustment activities within the claims department. Manages claims inventory, ensuring accurate and timely processing. Knowledge of various lines of business that the Sanford Health Plan services and how to differentiate services. Understands the details of professional and institutional claim processing which includes how benefits are assigned and pricing is calculated. Works to help develop and maintain claims policies and procedures. Must communicate effectively with a high level of diplomacy. Demonstrates analytical ability and a good awareness of pertinent details. Assimilates large amounts of information to maintain a broad knowledge base. Exercises good judgement in determining the best method for handling a variety of situations. Maintains good working relationships with staff, physicians, and enrollees. Handles pressure effectively. Maintains confidentiality. Other duties as assigned.Qualifications
Bachelor's degree preferred.Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-949-5678 or send an email to talent@sanfordhealth.org.
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Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Health care and social assistance and hospitals
10,000+ Employees
Sioux Falls, SD, US