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Remote Claims Processor Jobs in Pittsburgh, PA (NOW HIRING)

Gallagher

Senior Resolution Manager

Pittsburgh, PA · Remote

Whether you're managing claims, supporting clients, or improving processes, you'll play a vital ... Location: This role is fully remote work. How you'll make an impact * Apply claims management ...

Deloitte

Epic Denials Manager

Pittsburgh, PA · Remote

... process accounts and claims. Regularly monitors work queues and workflows in Epic, claims ... This is a remote role with minimal travel requirements. A successful candidate would possess these ...

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How much do remote claims processor jobs pay per hour?

As of Sep 10, 2026, the average hourly pay for remote claims processor in Pittsburgh, PA is $18.61, according to ZipRecruiter salary data. Most workers in this role earn between $15.87 and $20.05 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 Pittsburgh, PA?

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

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

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

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

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

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

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

Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Pittsburgh, PA as of September 2026, with employment types broken down into 75% Full Time, and 25% Part Time. Highlights an 100% Remote job distribution, with an average salary of $38,700 per year, or $18.6 per hour.

Pennsylvania Workers' Compensation Claims Adjuster (Remote)

Pittsburgh, PA • On-site, Remote

CCMSI
Insurance Services • 1 - 5K employees
Learn more about CCMSIexternal

$65K - $85K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 21 days ago

CCMSI rating

7.9

Company rating: 7.9 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

Job description

Overview
Workers' Compensation Claim Consultant - Pennsylvania
Location: Remote
Schedule: Monday - Friday, 8:00 AM - 4:30 PM EST
Salary Range: $65,000 - $85,000 annually
Build Your Career With Purpose at CCMSI
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.
Job Summary
The Workers' Compensation Claim Consultant is responsible for the investigation, evaluation, administration, and resolution of Pennsylvania Workers' Compensation claims from assignment through final closure. This role supports a dedicated carrier program and offers the opportunity to develop deep expertise within a single jurisdiction while building strong client and stakeholder relationships.
The successful candidate will manage a caseload of claims ranging from moderate complexity to more complex exposures depending on experience and skill level. Claims may include litigated matters, ongoing medical management, indemnity benefits, return-to-work coordination, and settlement opportunities.
This role is designed for experienced Pennsylvania Workers' Compensation adjusters who can independently manage a full inventory, exercise sound judgment, communicate effectively with all parties, and consistently deliver high-quality claim outcomes.
Responsibilities
When we hire Workers' Compensation Adjusters at CCMSI, we look for detail-driven problem-solvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust.
  • Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
  • Establish reserves and/or provide reserve recommendations within established reserve authority levels.
  • Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution.
  • Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
  • Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
  • Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
  • Assess and monitor subrogation claims for resolution.
  • Review and maintain personal diary on claim system.
  • Client satisfaction.
  • Prepare reports detailing claim status, payments and reserves, as requested.
  • Compute disability rates in accordance with state laws.
  • Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
  • Prepare newsletter articles, as requested.
  • Provide notices of qualifying claims to excess/reinsurance carriers.
  • Handle more complex and involved claims than lower level claim positions with minimum supervision.
  • Conduct claim reviews and/or training sessions for designated clients, as requested.
  • Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
  • Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Qualifications
Required Qualifications
  • 5+ years of Pennsylvania Workers' Compensation claims handling experience
  • Experience managing claims from investigation through closure
  • Strong knowledge of Pennsylvania Workers' Compensation laws and claim handling practices
  • Experience handling indemnity claims
  • Experience establishing reserves and evaluating claim exposure
  • Ability to independently manage a full caseload
  • Strong written and verbal communication skills
  • Effective negotiation and problem-solving abilities
  • Strong organizational, diary management, and time-management skills
  • Ability to work independently in a remote environment
  • Proficiency with Microsoft Office applications, including Outlook, Word, and Excel
  • Reliable attendance during established business hours

Preferred Qualifications
  • Carrier claims experience
  • Litigation management experience
  • Black Lung claims experience
  • Experience supporting dedicated claim programs
  • Prior TPA experience
  • Professional designations such as:
    • AIC
    • CPCU
    • ARM
    • WCP

Why You'll Love Working Here
  • 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
  • Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
  • Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
  • Career growth: Internal training and advancement opportunities
  • Culture: A supportive, team-based work environment

How We Measure Success
At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:
  • Quality claim handling - thorough investigations, strong documentation, well-supported decisions
  • Compliance & audit performance - adherence to jurisdictional and client standards
  • Timeliness & accuracy - purposeful file movement and dependable execution
  • Client partnership - proactive communication and strong follow-through
  • Professional judgment - owning outcomes and solving problems with integrity
  • Cultural alignment - believing every claim represents a real person and acting accordingly

This is where we shine, and we hire adjusters who want to shine with us.
Compensation & Compliance
The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.
CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.
Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.
ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.
Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.
Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.
Our Core Values
At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:
  • Lead with transparency We build trust by being open and listening intently in every interaction.
  • Perform with integrity We choose the right path, even when it is hard.
  • Chase excellence We set the bar high and measure our success. What gets measured gets done.
  • Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
  • Win together Our greatest victories come when our clients succeed.

We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.
#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #TPA #WorkersCompensation #WorkersCompClaims #PennsylvaniaWorkersComp #PAWorkersComp #WorkersCompAdjuster #ClaimsExaminer #IndemnityAdjuster #LitigatedClaims #BlackLungClaims #CarrierClaims #ClaimsCareers #InsuranceCareers #RemoteJobs #HiringNow #LIRemote #IND123

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