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Remote Claims Processor Jobs in Philadelphia, PA

LIO Insurance

Claims Examiner (Casualty)

Conshohocken, PA · On-site +1

$68K - $123K/yr

The Claims Examiner - Casualty is accountable for managing a portfolio of moderate complexity ... Simplicity - Striving for simplicity in our service, products, and processes. * Accountability ...

Ohm Systems, Inc

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Pharmacy Technician - Remote

Philadelphia, PA · Remote

$26.50 - $28.50/hr

Shift Position is remote. No time zone preference but shift times offered will be in EST time so ... Utilizes member claims history during the prior authorization review process * Makes outbound calls ...

Ohm Systems, Inc

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Prior Authorization Technician - Remote

Philadelphia, PA · Remote

$26.50 - $28.50/hr

Shift Position is remote. No time zone preference but shift times offered will be in EST time so ... Utilizes member claims history during the prior authorization review process * Makes outbound calls ...

USAA

Sr. TLE Auto Appraiser

Philadelphia, PA · On-site +1

$63K - $121K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Maintains accurate and current claim file documentation throughout the claims process for complex ...

USAA

Sr. Auto Appraiser - Field

Philadelphia, PA · On-site +1

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Maintains accurate and current claim file documentation throughout the claims process for complex ...

USAA

Sr. Auto Appraiser - Field

Philadelphia, PA · On-site +1

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Maintains accurate and current claim file documentation throughout the claims process for complex ...

North American Risk Services, Inc. (NARS)

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Sr. General Liability Claims Adjuster - NY Adjuster's License Needed

Philadelphia, PA · Remote

$85K - $95K/yr

Sr. General Liability Claims Adjuster - NY Adjuster's License Needed What You'll Do: · Maintain claim metrics; must be kept current. · Handle a case load commensurate with the complexity level of ...

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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 Philadelphia, PA is $18.24, according to ZipRecruiter salary data. Most workers in this role earn between $15.58 and $19.66 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.

More about Remote Claims Processor jobs

What are the most commonly searched types of Claims Processor jobs in Philadelphia, PA?

The most popular types of Claims Processor jobs in Philadelphia, PA are:

What are popular job titles related to Remote Claims Processor jobs in Philadelphia, PA?

For Remote Claims Processor jobs in Philadelphia, PA, the most frequently searched job titles are:

What job categories do people searching Remote Claims Processor jobs in Philadelphia, PA look for?

The top searched job categories for Remote Claims Processor jobs in Philadelphia, PA are:

What cities near Philadelphia, PA are hiring for Remote Claims Processor jobs?

Cities near Philadelphia, PA with the most Remote Claims Processor job openings:

Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Philadelphia, PA as of August 2026, with employment types broken down into 33% Full Time, and 67% Part Time. Highlights an 100% Remote job distribution, with an average salary of $37,929 per year, or $18.2 per hour.

Claims Examiner (Casualty)

LIO Insurance

Conshohocken, PA • On-site, Remote

$68K - $123K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 3 days ago

Job description

Summary/Objective:
The Claims Examiner – Casualty is accountable for managing a portfolio of moderate complexity general liability claims across admitted and E amp;S products, including exposure to construction-related and construction defect property damage claims, driving each claim from initial notice through resolution. This role requires applying sound coverage analysis, leading investigations, evaluating liability and damages, and crafting clear, defensible coverage positions. The Claims Examiner will proactively negotiate with claimants and attorneys, ensure timely and accurate claim payments, and deliver a high-quality claims experience. The ideal candidate is a strong communicator and critical thinker who can effectively engage with insureds, brokers, counsel, and internal partners while balancing customer experience, financial outcomes, and regulatory compliance.
Essential Duties amp; Functions:
  • Manage a portfolio of moderate complexity casualty claims, including general liability and select construction-related / construction defect property damage exposures
  • Handle claims across admitted and E amp;S platforms, applying sound judgment and seeking guidance on complex or high-exposure matters
  • Perform coverage analysis and policy interpretation, including drafting coverage positions for moderately complex claims and supporting more complex or layered matters
  • Conduct thorough investigations, evaluate liability and damages, and establish and adjust reserves in accordance with claim developments
  • Coordinate and actively manage defense counsel, experts, and vendors to ensure effective case strategy and cost control
  • Support the development and execution of litigation and settlement strategies aligned with claim facts, coverage, and business objectives
  • Participate in mediations, settlement negotiations, and discussions with claimants and counsel as appropriate
  • Maintain accurate, timely, and well-documented claim files, including clear reporting and adherence to internal guidelines and regulatory requirements
  • Proactively identify and escalate complex, high-severity, or coverage-sensitive issues to senior team members
LIO LIFE – What we value:
  • The Customer Lens – Prioritizing our relationships, service and needs of our customers.
  • Innovative Thinking – Fostering an environment that empowers and sustains bold thinking and actions.
  • Balance – Creating an inclusive, diverse, and holistic balance to meet our personal and professional needs.
  • Simplicity – Striving for simplicity in our service, products, and processes.
  • Accountability – Owning our results and learning from them.
Qualifications:
To perform this role successfully, an individual must be able to execute each essential duty effectively. The requirements below represent the key competencies needed. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Strong written and verbal communication skills, including the ability to clearly convey complex information and actively listen to understand key issues
  • Sound judgment and decision-making abilities, with the capacity to evaluate risk, think critically, and escalate appropriately
  • High degree of integrity and professionalism, with a strong commitment to confidentiality and ethical conduct
  • Customer-focused mindset, delivering responsive, solutions-oriented service to both internal and external stakeholders
  • Ability to build effective working relationships and collaborate across teams and levels, while also operating independently
  • Strong organizational and time management skills, with the ability to prioritize, manage competing demands, and meet deadlines
  • Analytical mindset, with the ability to assess information, identify key drivers, and support well-reasoned outcomes
  • Ability to influence, negotiate, and navigate challenging conversations with professionalism and confidence
  • Adaptability and accountability in a dynamic, fast-paced, and primarily virtual work environment
  • Demonstrated respect for diverse perspectives and the ability to work effectively across varied backgrounds and experiences
  • Ownership mindset, with the ability to plan, organize, and execute work from initiation through completion
  • Comfort working in a lean, entrepreneurial environment, with a willingness to take initiative and adapt to evolving priorities
Required Education and Experience:
  • Bachelor’s degree or equivalent combination of education and relevant experience
  • 3–6+ years of casualty claims handling experience
  • Experience handling general liability (GL) claims required; exposure to construction-related or construction defect claims preferred
  • Active state adjuster license(s) or ability to obtain required licenses within a defined timeframe
Preferred Education and Experience:
  • CPCU and/or AI
Additional Eligibility Requirements (Certificates, Licenses, Required/Preferred):
  • CPCU or AIS
Benefits:
As a core value, LIO Insurance understands the importance of balance to meet both personal and professional needs. Our benefits include:
  • Flexible (unlimited) Time Off and 13 paid holidays
  • 401k
  • Maternity Leave
  • Competitive Medical to support holistic health
    • Medical, dental/ortho, vision, life and disability insurance
    • HSA/FSA/DCAP savings plans
Work Environment:
This job operates in a professional office environment. This role routinely uses standard office equipment.
Position Type/Expected Hours of Work:
This is a full-time position. Expected days and hours of work are Monday through Friday, 8:30 a.m. to 5 p.m. This position may require long hours and weekend work.
Travel:
Occasional travel may be necessary for this position – to attend mediations, trials, or large property loss exposures.
EEO Statement:
LIO Insurance provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, creed, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Other Duties:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

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