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

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 ...

Adecco

Customer Support Representative

Rio Rancho, NM · On-site +1

$19.59/hr

... is fully Remote. This role may require flexibility in work hours, including occasional extended hours to support operational demands. This Customer Solutions Representative position is being ...

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All JobsClaims Processor JobsRemote Claims Processor JobsRemote Claims Processor Jobs in Rio Rancho, NM

Remote Claims Processor information

See Rio Rancho, NM salary details

$11

$18

$24

How much do remote claims processor jobs pay per hour?

As of Jul 19, 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.
Medical Coding Specialist

Medical Coding Specialist

Ensemble Health Partners

Albuquerque, NM • Remote

$20.45 - $24.70/hr

Full-time

Posted 4 hours ago

Posted today

Ensemble Health Partners rating

6.5

Company rating: 6.5 out of 10

Based on 239 frontline employees who took The Breakroom Quiz

140th of 148 rated financial services

Job description

CAREER OPPORTUNITY OFFERING:

  • Bonus Incentives

  • Paid Certifications

  • Tuition Reimbursement

  • Comprehensive Benefits

  • Career Advancement

  • This position will pay between $20.45 - $24.70/hr based on experience

​

We are seeking candidates with experience in multiple pro-fee specialties: Hem/Onc, Interventional Radiology, CVTS, Ortho, Podiatry, Wound Care, Rad/ONC, General Surgery, Allergy and ENT, OBGYN, Radiology and Urology

The Medical Coding Specialist position reviews medical record documentation and accurately assign ICD-10-CM, ICD-10-PCS, as well as CPT IV codes based on the specific record type and abstract specific data elements for each case in compliance with federal regulations. This position codes all types of outpatient visits to include ancillary, urgent care, emergency department, observation, same day surgery, and interventional procedures. Follows the Official Guidelines for Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as the American Hospital Association, (AHA) Coding Clinics, CMS directives and Bulletins, Fiscal Intermediary communications. Utilizing Coding Applications in accordance with established workflow. Follows Policies and Procedures and maintains required quality and productivity standards.

Job Responsibilities:

  • Reviews medical record documentation and accurately assigns appropriate ICD-9-CM, ICD-10, CPT IV, and HCPCS codes utilizing the 3M software tools for all OP Work Types. The assigned codes must support the reason for the visit and the medical necessity that is documented by the provider to support the care provided. When applicable, apply the appropriate charges such as the Evaluation & Management, (E&M) level and injections and infusions, and/or other necessary requirements for Observation cases, using a third party software systems such as LYNX.

  • Correctly abstract required data per facility specifications.

  • Perform "medical necessity checks" for Medicare and other payers as required per payment guidelines.

  • Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis as a team, ensure timely, compliant processing of outpatient claims in the billing system.

  • Responsible to maintain established productivity requirements, key performance indicators established for 3M 360 CAC for CRS & Direct Code as well as ensure accuracy to maintain established quality standards.

  • Remain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through.

  • Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding, (CAC) Medical Necessity software, abstracting system, code books, and all reference materials. Reports inaccuracies found in Coding Software to HIM Management/Supervisor, reports any potential unethical and/or fraudulent activity per compliance policy

  • Attends required system, hospital and departmental meetings and educational sessions as established by leadership, as well as completion of required annual learning programs, to ensure continued education and growth.

Experience We Love:

  • 1 year of previous of coding experience

  • PC and Computer application knowledge and experience. Navigational and basic functional expertise in Microsoft business software (Excel, Word, PowerPoint).

  • Excellent organization skills, communication, time management, trouble shooting and problem solving.

  • Ability to multi-task and prioritize needs to meet short- and long-term timelines.

  • Experience with EPIC and previous use of coding software tools.

  • Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences

  • This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

Minimum Education:

  • High School Diploma or GED

Required Certifications:

  • AAPC or AHIMA Coding Certification: CPC-A, CPC, CCA or CCS

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