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Remote Claims Processor Jobs in Raleigh, NC (NOW HIRING)

VIVA USA INC

MES Reporting Analyst

Raleigh, NC · On-site +1

... claims processing, eligibility, HHS analytics) - Required - 5 Years Notes: Remote VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all ...

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All JobsRemote Claims Processor JobsRemote Claims Processor Jobs in Raleigh, NC

Remote Claims Processor information

See Raleigh, NC salary details

$11

$18

$25

How much do remote claims processor jobs pay per hour?

As of Jul 1, 2026, the average hourly pay for remote claims processor in Raleigh, NC is $18.63, according to ZipRecruiter salary data. Most workers in this role earn between $15.87 and $20.10 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 Raleigh, NC? For Remote Claims Processor jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Raleigh, NC look for? The top searched job categories for Remote Claims Processor jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Claims Processor jobs? Cities near Raleigh, NC with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you

Claims Processor

Marpai Administrators LLC

Cary, NC • Remote

$24 - $30/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

Job description

Marpai Administrators is a technology company transforming the Third-Party Administration sector serving employers with self-funded health plans. Marpai Administrators (Marpai) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. We create healthier members and a healthier bottom line. Marpai proactively targets at-risk members with meaningful clinical interventions to improve outcomes.
ABOUT THE POSITION:
The Claims Processor will be responsible to for reviewing claims for accuracy, completeness, and eligibility. The Claims Processor is responsible to adjudicate claims, complete work assignments and meet established departmental metrics.
WHAT YOU WILL BE DOING:
  • Data entry of claims into system.
  • Review, analyze adjudicate claims
  • Validate the information on all claims to ensure there is no missing or incomplete information
  • Ability to understand and apply benefits as outlined in plan document
  • Maintain/manage all claim inventories in accordance with health plan and regulatory policies
  • Display maturity, composure and ability to operate under stressful conditions.
  • Complete daily assignments and update required spreadsheet
  • Complete end of day summary
  • Flexibility to change work direction as determined by management
  • Meet departmental standards for quality, production and attendance.
  • Analyst is flexible and able to commit to overtime based on business needs
  • Other duties as required

WHAT DO YOU NEED
  • Associates degree preferred
  • 2+ yrs claims processing
  • Strong analytical, research, and communication skills.
  • Expansive knowledge of medical terminology.
  • Excellent verbal and written communication skills as well as exemplary organizational skills.
  • Work closely with leadership to assist in mitigating trends as necessary.
  • Independent judgment in decision-making and problem solving.
  • Computer skills in MS Word, Excel, PowerPoint, & Outlook at the intermediate or higher level.
  • Ability to multi-task & anticipate potential needs/problems.
  • Strong attention to detail.
  • Ability to understand and apply on-line documentation policies and procedures.
  • Excellent customer services skills including an ability to follow through, take ownership and drive all assigned tasks to completion.
  • Ability to handle large volumes of work, solve problems and manage multiple assignments while meeting critical deadlines.
  • HIPAA Compliance

WORK REQUIREMENTS:
  • Fast paced, dynamic work environment requiring the ability to be adaptive, innovative and flexible
  • Travel minimal

WHY WORK AT MARPAI?
We have great benefits:
  • Generous PTO
  • Medical and Prescription
  • EAP
  • FSA / HSA / Dependent Care
  • Dental
  • Vision
  • Life and Disability
  • STD/LTD
  • Voluntary Benefits: Critical Illness, Accident, Hospital
  • 401k with Employer Match
  • LegalShield
  • Identity Theft Protection

Marpai is an equal opportunity workplace. We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.

This is a remote position.