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Remote Claims Processor Jobs in Quincy, MA (NOW HIRING)

Capstone Search Group

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Senior Claims Adjuster, Workers Compensation - Remote (10226)

Boston, MA · Remote

$65K - $95K/yr

As Senior Claims Adjuster, Workers Compensation you are responsible for managing the process from ... Fully remote but requires experience with workers compensation claims in the following states ...

Liberty Mutual

Environmental Claims Officer

MA · On-site +1

We will also consider highly qualified remote candidates who do not reside near a hub location ... Support audit and compliance processes while maintaining required adjuster licenses and ...

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Remote Claims Processor information

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How much do remote claims processor jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for remote claims processor in Quincy, MA is $20.15, according to ZipRecruiter salary data. Most workers in this role earn between $17.16 and $21.73 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 are popular job titles related to Remote Claims Processor jobs in Quincy, MA? For Remote Claims Processor jobs in Quincy, MA, the most frequently searched job titles are:
What cities near Quincy, MA are hiring for Remote Claims Processor jobs? Cities near Quincy, MA with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Quincy, MA as of July 2026, with employment types broken down into 2% As Needed, 94% Full Time, 2% Part Time, and 2% Contract. Highlights an 2% In-person, and 98% Remote job distribution, with an average salary of $41,915 per year, or $20.2 per hour.

ACO Medicaid Claims Review Specialist

Massgeneralbrigham

Somerville, MA • Remote

Full-time

Medical

Posted 13 days ago

Job description

Site: Mass General Brigham Health Plan Holding Company, Inc.


Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.


Job Summary

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.
We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.
Job Description Summary
Review claims to ensure accurate coding, appropriate documentation, and compliance with applicable billing regulations and payer guidelines.
Adjudicate claims to pay, deny, or pend as appropriate in a timely and accurate manner according to company policy and desktop procedure.
Review and research assigned claims by navigating multiple systems and platforms, then accurately capturing the data/information necessary for processing (e.g., verify pricing/fee schedules, contracts, prior authorization, applicable member benefits).
Communicate and collaborate with external departments to resolve claims errors/issues, using clear and concise language to ensure understanding.
Review and adjudicate medical claims submitted by healthcare providers, insurance companies, and patients to identify discrepancies, errors, or potential fraud.
Analyze and validate the assigned diagnosis codes (ICD-10) and procedure codes (CPT) on medical claims to ensure accurate representation of services rendered and compliance with coding standards.
Keep up to date with Desktop Procedures and effectively apply this knowledge in the processing of claims and in providing customer service.
Identify and escalate system issues, configuration issues, pricing issues etc. in a timely manner.
Ensure that the medical claims include complete and accurate documentation supporting the services rendered, including physician notes, test results, and other relevant records.
Meet the performance goals established for the position in areas of productivity, accuracy, and attendance that drives member and provider satisfaction.


Qualifications

Education

  • High School Diploma or Equivalent required
  • Associate's Degree preferred


Licenses and Credentials

  • Professional Coder (CPC) license preferred
  • Pharmacy Technician certification and/or a degree in a pharmacy-related field preferred

Experience

  • At least 1-2 years of healthcare billing experience required
  • At least 2-4 years of experience in healthcare claims processing, billing, or the health insurance industry (e.g., hospital or physician billing) highly preferred
  • Experience in pharmacy claims processing or adjudication, with a strong working knowledge of pharmacy terminology and National Drug Code (NDC) standards.
  • Experience with core healthcare claims processing and billing system highly preferred
  • Strong working knowledge of managed care concepts and medical coding, including ICD-10, CPT, HCPCS, and Revenue Codes highly preferred


Knowledge, Skills, and Abilities

  • Knowledge of Medicaid/ACO claims processing
  • Knowledge of claim types including professional, facility, DME, outpatient, and inpatient
  • Ability to prioritize and manage aged claims (e.g., 30+ day inventory) to meet program guidelines and turnaround requirements
  • Strong attention to detail and accuracy in claim review, submissions, and documentation
  • Familiarity with insurance plans, government programs, and their billing requirements.
  • Strong attention to detail and accuracy in claim submissions and recordkeeping.
  • Excellent communication skills, both written and verbal, to interact effectively with insurance companies, patients, and colleagues.
  • Strong customer service orientation and ability to handle sensitive or difficult situations with empathy and professionalism.


Additional Job Details (if applicable)

Working Conditions

  • This is a full-time role with a Monday through Friday, 8:30-5 schedule

  • This is a remote role that can be done from most US states


Remote Type

Remote


Work Location

399 Revolution Drive


Scheduled Weekly Hours

40


Employee Type

Regular


Work Shift

Day (United States of America)


Pay Range

$17.71 - $25.28/Hourly


Grade

2


At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.


EEO Statement:

8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.


Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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