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Remote Claims Processor Jobs in Rio Rancho, NM (NOW HIRING)

Workit Health

RCM Specialist

Albuquerque, NM · On-site +1

$18.75 - $25.75/hr

M-W in office and Th-F remote each week Job Summary: Workit Health is seeking a full-time RCM ... Identify and resolve claims processing issues, including pre-submission errors, and generate ...

BCForward

Customer Service Representative

Albuquerque, NM · Remote

$19 - $19.90/hr

Remote Duration: 18+ months with possible extension Start Date: 08/24/2026 Pay Rate: $19.90/hour on W2 Job Responsibilities Answer incoming phone calls, chats, and/or emails Conduct outreach phone ...

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Remote Claims Processor information

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$11

$18

$24

How much do remote claims processor jobs pay per hour?

As of Jul 18, 2026, the average hourly pay for remote claims processor in Rio Rancho, NM is $18.03, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $19.42 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 Rio Rancho, NM? For Remote Claims Processor jobs in Rio Rancho, NM, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Rio Rancho, NM look for? The top searched job categories for Remote Claims Processor jobs in Rio Rancho, NM are:
What cities near Rio Rancho, NM are hiring for Remote Claims Processor jobs? Cities near Rio Rancho, NM with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Rio Rancho, NM as of July 2026, with employment types broken down into 80% Full Time, and 20% Part Time. Highlights an 100% Remote job distribution, with an average salary of $37,496 per year, or $18 per hour.
AVP, Claims & Judi Strategy - Remote

AVP, Claims & Judi Strategy - Remote

Prime Therapeutics LLC

Albuquerque, NM • On-site, Remote

$164K - $279K/yr

Full-time

Posted 8 days ago

Prime Therapeutics rating

7.8

Company rating: 7.8 out of 10

Based on 47 frontline employees who took The Breakroom Quiz

15th of 104 rated pharmacies

Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting Title
AVP, Claims & Judi Strategy - RemoteJob Description
The AVP, Claims & Judi Strategy is responsible for defining and driving the enterprise vision and multi-year strategy for the claims block, ensuring alignment across key stakeholders. This role partners cross-functionally to identify improvement opportunities, set realistic delivery expectations, and lead large-scale initiatives that enhance claims capabilities, technology, and operational efficiency. This position oversees development and management of the business value case to support strategic investment in the roadmap.
Responsibilities
  • Define and lead the multi-year claims technology and capability strategy, including roadmap development for claims platforms, capacity planning, prioritization of enhancements, and assessment and sunsetting of claims-adjacent systems to reduce complexity and improve efficiency in partnership with key stakeholders
  • Lead and communicate the enterprise vision for claims block, ensuring alignment to roadmap across business units and active engagement with peer block owners to identify gaps, challenge existing processes, and drive continuous improvement across claims capabilities
  • Establish clear delivery boundaries and expectations in partnership with account management, aligning on client commitments and operational feasibility
  • Drive education, communication, and adoption strategies across business units and functional teams, including the development of business case vision and value for investment
  • Partner with Claims Operations, Configuration Operations, and Strategic Solutions teams to lead large-scale, high-impact initiatives that improve claims outcomes and business performance
  • Assess and manage external partner impacts and dependencies, ensuring alignment with organizational capabilities, contractual obligations, and long-term strategic goals
  • Remain aware of leading-practice industry technologies, including AI, and ensure future-state roadmaps responsibly include leading-edge technological capabilities
  • Other duties as assigned

Minimum Qualifications
  • Bachelor's degree in Business, Healthcare Administration or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma from an accredited school or GED is required
  • 12 years of work experience in project management, portfolio management or operations
  • 8 years of leadership/people management experience
  • Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications
  • Demonstrated ability to communicate effectively, both verbal and written, and the proven ability to work effectively with all organizational levels and external contacts
  • Strong strategic-thinking, analytic, and problem-solving skills
  • Excellent facilitation, presentation, and consultative skills; skilled at managing meetings and listening with the ability to interpret information into consistent and concise actions that drive results
  • Ability to effectively drive business and lead transformation in a dynamic and complex operating environment
  • Strong conflict management skills with ability to influence and drive stakeholders to most impactful outcomes
  • Understanding of adjudication engines and technical risk management

Preferred Qualifications
  • Master of Business Administration
  • Pharmacy Benefit Management or healthcare experience

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job
Potential pay for this position ranges from $164,000.00 - $279,000.00 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.

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About Prime Therapeutics

Sourced by ZipRecruiter

Prime Therapeutics, located in Eagan, MN, is a pharmacy benefits management company that has been serving the healthcare industry since its foundation. They are an integral participant in the medical sector, specifically in the realm of health insurance. They focus on providing innovative pharmacy benefits and services to more than 30 million members nationwide. Besides their main pharmacy benefit management, they offer mail service pharmacy, specialty pharmacy, benefits management, and consultative engagement services to ensure individuals have continuous access to affordable prescription drugs. Prime Therapeutics, founded around three decades ago, has grown to stand out as a leader in its industry, thanks to its commitment to improving the health of its clients.

Industry

Insurance services

Company size

1,001 - 5,000 Employees

Headquarters location

Eagan, MN, US

Year founded

1987

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