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Remote Claims Processor Jobs in Opelika, AL (NOW HIRING)

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Remote Claims Processor information

See Opelika, AL salary details

$11

$17

$24

How much do remote claims processor jobs pay per hour?

As of Aug 1, 2026, the average hourly pay for remote claims processor in Opelika, AL is $17.60, according to ZipRecruiter salary data. Most workers in this role earn between $15.00 and $18.99 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 cities near Opelika, AL are hiring for Remote Claims Processor jobs? Cities near Opelika, AL with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Opelika, AL as of July 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $36,599 per year, or $17.6 per hour.

Associate Director, Access & Reimbursement (ADAR) CV- South Atlanta, GA

Novartis

Columbus, GA • Remote

Full-time

Medical, Retirement, PTO

Posted 24 days ago

Novartis rating

7.5

Company rating: 7.5 out of 10

Based on 17 frontline employees who took The Breakroom Quiz

64th of 86 rated pharmaceutical

Job description

Job Description Summary

#LI-Remote
The AD, Access & Reimbursement, NPSCVis in South Atlanta, GA geography. This is a remote& field-based role that covers thefollowing, butnot limited to:South Atlanta, Lawrenceville, GA, Savannah, and Columbus, GA. Associatemustresidewithin territory, or within a reasonable daily commuting distance of 60 miles from territory.
The Associate Director, Access & Reimbursement (ADAR) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their assigned geographies on a wide range of access and reimbursement topics and needs (see below) in support of aligned product(s) strategy. ADARs primarily focus on accounts with increased process and workflow complexity, typically including centralized and decentralized systems of care, integrated delivery networks, academic medical institutions, large multi-provider specialty practices, and alternate sites of care.
ADARs will serve as the patient access and reimbursement lead in business-to-business conversations with account executives. The ADAR role is responsible for managing the pull-through of access and reimbursement strategy and downstream operations within their aligned accounts. ADARs are expected to have deep expertise in communicating requirements and addressing barriers associated with local payer policy coverage, multi-channel acquisition pathways, billing and coding education (as needed), claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows. ADAR will continually need to demonstrate a keen ability to problem solve and manage multiple projects.
ADARs partner closely with other Novartis Pharmaceuticals Corporation (NPC) field associates, including Customer Engagement (Sales) and Market Access, representing NPC with the highest integrity in accordance with NPC Values and Behaviors. ADARs will also be required to coordinate and communicate cross-functionally within NPC (e.g., Patient Support Center, Customer Engagement, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management, and other applicable third-party affiliates).


Job Description

Key Responsibilities:

  • Interact with large, complex accounts to support patient access within their aligned therapeutic area product(s), proactively provide face-to-face education on programs to providers and staffin order tosupport integration of those products into office processes and workflows.

  • Work with key members of therapeutic area offices (e.g., executives, providers, administrators, billing and coding staff, claims departments, revenue cycle managers)in order toappropriately support patient access to products.

  • Ability to analyze problems and offer solutions. Understand specifics and support questions associated with patient reimbursement and provide support on reimbursement issues with third party payers at the provider-level. Analyze account reimbursement issues (as needed).

  • Supports pullthrough onlocal coverage decisions to enable meaningful patient access within the system.Proactively communicate policy changes or issues that could potentially affect other departments.

  • Maintainexpertisein regional and local access landscape,anticipatingchanges in the healthcare landscape, and act as their aligned therapeutic area product(s) reimbursement expert (as needed).

  • Interface with Patient Support Center (hub) and Access & Reimbursement Managers on important matters related to patient case management, including tracking cases, issue resolution, reimbursement support, andappropriate officestaff education.

  • Collaborate with aligned cross-functional associates within NPC (see above) to share insights on customer needs and barriers for their aligned therapeutic area product(s) related to access and reimbursement.

  • Responsible for educating HCPs using approved materialsregardingacquisition pathways for Novartis products. Educate on buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate site of care for administration.

Buy and Bill Specific

  • Assessaccesssituation within the assigned geography and developappropriatePlan of Action (POA).Communicate POA toappropriate personnel.

  • Responsible for educating HCPs using approved materialsregardingacquisition pathways for Novartis products. Educate on buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate site of care for administration.

  • Educates relevant stakeholders onlogisticsrelated to ordering, payment, inventory, and product returns & replacement.

  • Analyze reimbursement issues,anticipatingchanges in the healthcare landscape, and act as the designated reimbursement expert for offices and field teams.

  • Accountable for engagement with non-prescribersin regards toNovartis medicines, for example pharmacy, system leadership, financial counselors, office administrators, revenue cycle managers, etc.

MinimumRequirements:

  • Education:Bachelor's Degreerequired.Business and/or biological science education preferred. Advanced degree preferred.

  • 5+ Years of experience in pharmaceuticals / biotech industry focusedinPatient Services, Market Access, Sales, and/or account management. With 2 of those years being in a Patient Services practice support role for a specialty product(s).

  • Experience working withhighly complexpractices and/or health systems toestablishaccess and acquisition pathways.

  • Strategic account management experienceusinga proactive approach toanticipateaccess hurdlesimpactingaccounts and patient access.

  • Deepexpertiseand experience integrating manufacturer-sponsored patient support programs.

  • Experience with specialty productsacquiredthrough Specialty Pharmacynetworks.

  • Knowledge of reimbursement pathways (specialty pharmacy, buy-and-bill, retail).

  • Candidate mustresidewithin territory, or within a reasonable daily commuting distance of60miles from the territory border.Abilityto travel 60-80% over a broad geography isrequired, with the ability to drive and/or fly within the territory.Musthave a valid driver's license.

Novartis Compensation Summary:

The salary for this position is expected to range between $160,300,and $297,700per year.

The final salary offered isdeterminedbased on factors like, but not limited to, relevant skills and experience, and upon joining Novartis will be reviewed periodically. Novartis may change the published salary range based on company and market factors.

Your compensation will include a performance-based cash incentive and, depending on the level of the role, eligibility to be considered for annual equity awards.

US-based eligible employees will receive a comprehensive benefits package that includes health,lifeand disability benefits, a 401(k) with company contribution and match, and a variety of other benefits. In addition, employees are eligible for a generous time off package including vacation, personal days,holidaysand other leaves.

Driving is an Essential Function of this Role:Meaning it is fundamental to the purpose of this job and cannot be eliminated. Because driving is an essential function of the role, you must have a fully valid and unrestricteddriver'slicense to be qualified for this role. The company provides reasonableaccommodationsfor otherwise qualified individuals with medical restrictions ifan accommodationcan be provided withouteliminatingthe essential function of driving.

COVID-19 Vaccine Policy (customer-facing roles only):While Novartis does not require vaccination for COVID-19 or proof of a recent negative test result for COVID-19 at this time, employees working in customer-facing roles must adhere to and comply with customers' (such as hospitals, physician offices, etc.) credentialing guidelines, which may require vaccination. As required by applicable law, Novartis will consider requests for reasonable accommodation for those unable to be vaccinated. This requirement is subject to applicable state and local laws and may notbe applicableto employees working in certainjurisdictions. Please send accommodation requests toEh.occupationalhealth@novartis.com

For Field Roles with a Dedicated Training Period:

The individual hired for this role will berequiredto successfully complete certaininitialtraining, including home study, eight (8) or fewer hours perdayand forty (40) or fewer hours per week.


EEO Statement:

The Novartis Group of Companies are Equal Opportunity Employers. We do not discriminate in recruitment, hiring, training, promotion or other employment practices for reasons of race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, marital or veteran status, disability, or any other legally protected status.


Accessibility and reasonable accommodations

The Novartis Group of Companies are committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or to perform the essential functions of a position, please send an e-mail to us.reasonableaccommodations@novartis.com or call +1(877)395-2339 and let us know the nature of your request and your contact information. Please include the job requisition number in your message.


Salary Range

$160,300.00 - $297,700.00


Skills Desired

Access And Reimbursement Strategy (Inactive), Agility (Inactive), Analytical Skill (Inactive), Analytical Thinking, Cross-Functional Collaboration, Customer-Centric Mindset (Inactive), Employee Development, Finance, Go-to-Market Strategies, Healthcare Policies, Healthcare Sector Understanding (Inactive), Health Economics, Health Technology Assessment (HTA), Innovation, Inspirational Leadership, Market Access Strategies, People Management, Process Management, Project Management, Public Affairs, Real World Evidence (RWE), Regulatory Compliance, Risk Management, Value Propositions

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