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Remote Claims Processor Jobs in McKinney, TX (NOW HIRING)

UnitedHealth Group

Life Claims Analyst

Dallas, TX · Remote

$49K - $88K/yr

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within ... OnBase claims processing system experience Telecommuting Requirements: * Ability to keep all ...

NTT DATA Services

Business Analyst - Claims

Mckinney, TX · On-site +1

$117K - $196K/yr

Document current-state claims processes, workflows, and business requirements. * Facilitate ... The starting pay range for this remote role is $117,600.00 to $196,000.00. This range reflects the ...

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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 6, 2026, the average hourly pay for remote claims processor in McKinney, TX is $17.79, according to ZipRecruiter salary data. Most workers in this role earn between $15.19 and $19.18 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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Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in McKinney, TX as of August 2026, with employment types broken down into 87% Full Time, 10% Part Time, and 3% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $36,995 per year, or $17.8 per hour.

Senior Data Analyst Claims Reconciliation

Vytwo

Prosper, TX • Remote

$88K - $111K/yr

Full-time

Posted 2 days ago

New

Job description


Senior Data Analyst – Claims Reconciliation
Role Type: Senior Data Analyst
Duration: 5+ months
Location: U.S.-based; candidates must be available for meetings between 8:00 a.m. and 5:00 p.m. Eastern Time.
Position Summary
We are seeking a Senior Data Analyst to support the development of a Claims Reconciliation Hub. This role will focus on defining and analyzing matching criteria between pre-service member- and provider-facing cost estimates and actual medical claims submitted and adjudicated across multiple lines of business.
The ideal candidate brings extensive healthcare claims data experience, strong Snowflake and data warehousing capabilities, and a working knowledge of health plan claims processing. This individual will partner closely with business analytics stakeholders to identify relevant data sources, interpret complex claims data elements, trace claim activity through the adjudication lifecycle, and uncover patterns that support accurate estimate-to-claim matching.
Key Responsibilities
  • Support the Reconciliation Hub initiative by defining matching criteria between pre-service estimates and final adjudicated medical claims.
  • Analyze claims data across major healthcare platforms to identify patterns, relationships, and reconciliation opportunities.
  • Trace claims from initial receipt and pre-adjudication through final adjudication, payment, and reporting.
  • Partner with business analytics teams to identify the appropriate data tables, attributes, identifiers, and source-system relationships needed for reconciliation analysis.
  • Explain and document how key membership, provider, benefit, pricing, and claims-processing data elements should be interpreted and applied.
  • Analyze claim changes occurring throughout the processing lifecycle, including edits, benefit determination, prior authorization matching, documentation requests, contract-based pricing, accumulators, and payment batching.
  • Develop insights that improve the ability to match member- and provider-facing estimates with actual submitted and adjudicated claims.
  • Perform data exploration and analysis using Snowflake and enterprise healthcare data warehouse assets.
  • Document data logic, source-to-target relationships, matching rules, assumptions, findings, and identified data gaps.
  • Communicate complex analytical findings clearly to technical and nontechnical stakeholders.
  • Support reconciliation design across multiple lines of business and healthcare claims platforms.
Required Qualifications
  • 5+ years of experience as a Data Analyst supporting data warehousing, enterprise data, and healthcare data initiatives.
  • 3+ years of internal experience analyzing healthcare claims data and core healthcare data assets, including enterprise data warehouse environments such as UDW.
  • Experience working with healthcare claims platforms, including CSP Facets, UNET, COSMOS, and USP.
  • Strong understanding of medical claims coding, billing, processing, adjudication, and payment workflows.
  • Familiarity with member, subscriber, provider, and plan identifiers and their use across claims data.
  • Knowledge of core claims processing capabilities, including:
    • Benefit determination
    • Claims editing
    • Prior authorization matching
    • Documentation or medical-record requests
    • Contract-based pricing
    • Deductible and out-of-pocket accumulators
    • Payment and batching processes
  • Experience using Snowflake for data analysis, data exploration, and querying healthcare data.
  • Strong analytical and problem-solving skills, with the ability to identify patterns across complex claims-processing data.
  • Excellent communication, collaboration, and stakeholder-management skills.
  • Ability to work independently and effectively in a fast-paced, dynamic project environment.
  • Must be U.S.-based and available for meetings between 8:00 a.m. and 5:00 p.m. ET.
Preferred Qualifications
  • Experience using AI/ML tools, models, or analytical techniques to support data analysis, pattern identification, reconciliation, or healthcare analytics.
  • Experience supporting healthcare cost-estimation, price-transparency, member financial responsibility, or claims reconciliation initiatives.
  • Experience designing or documenting data-matching logic, reconciliation rules, or cross-platform data lineage.

This is a remote position.