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Remote Claims Processor Jobs in Silver Spring, MD

C-MCI

Medical Billing Specialist

Fairfax, VA · On-site +1

$18.50 - $24/hr

Remote / On-site Department: Revenue Cycle Management Overview: CMCI is seeking a detail-oriented and experienced Medical Billing Specialist to oversee claims processing, revenue cycle management ...

Freedom Mortgage

Specialist, FHA Claims

Columbia, MD · On-site +1

Summary The Specialist, FHA Claims is responsible for the filing of all FHA Part B claims and all ... Proficient in computer skills and knowledge of word processing, spreadsheets, accounting general ...

System One

Client Relationship Manager

Baltimore, MD · Remote

Hybrid - onsite and remote We're looking for a Client Relationship Manager who thrives in a fast ... of medical claims experience (claims processing, denials, investigations, or claims issue ...

System One

Client Relationship Manager

Baltimore, MD · Remote

Hybrid - onsite and remote We're looking for a Client Relationship Manager who thrives in a fast ... of medical claims experience (claims processing, denials, investigations, or claims issue ...

System One

Client Relationship Manager

Baltimore, MD · Remote

Hybrid - onsite and remote We're looking for a Client Relationship Manager who thrives in a fast ... of medical claims experience (claims processing, denials, investigations, or claims issue ...

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Remote Claims Processor information

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$27

How much do remote claims processor jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for remote claims processor in Silver Spring, MD is $19.81, according to ZipRecruiter salary data. Most workers in this role earn between $16.88 and $21.39 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 Silver Spring, MD? For Remote Claims Processor jobs in Silver Spring, MD, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Silver Spring, MD look for? The top searched job categories for Remote Claims Processor jobs in Silver Spring, MD are:
What cities near Silver Spring, MD are hiring for Remote Claims Processor jobs? Cities near Silver Spring, MD with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Silver Spring, MD as of July 2026, with employment types broken down into 81% Full Time, 17% Part Time, and 2% Contract. Highlights an 84% Physical, 6% Hybrid, and 10% Remote job distribution, with an average salary of $41,210 per year, or $19.8 per hour.
Principal Solutions Architect - Claims Processing (Remote)

Principal Solutions Architect - Claims Processing (Remote)

CareFirst

Baltimore, MD • Remote

Other

Retirement

Posted 15 hours ago

CareFirst BlueCross BlueShield rating

7.3

Company rating: 7.3 out of 10

Based on 31 frontline employees who took The Breakroom Quiz

219th of 281 rated insurance

Job description

Resp & Qualifications

PURPOSE: 
Responsible for establishing strategic technology direction and creating solution architecture for large complex initiatives/projects. Responsible for the strategic design of technical solutions for complex business problems that are in line with established and emerging technology standards, patterns, and best practices. Primary accountability for architecture work takes place during the lifecycle of major transformation/modernization Initiatives/projects, from planning through implementation. Provides technical oversight and strategic direction to IT project teams in order to deliver key solutions to business problems.
ESSENTIAL FUNCTIONS:

Translate business strategy into solution architecture:

  • Accountable for leading the Solution Architecture deliverables for large complex portfolio, program or product line, which aligns with enterprise architecture and links the high-level architecture, business requirements, and technology standards into a cohesive solution. Responsible for defining and communicating a shared technical and architecture vision across the portfolio/program. Provides foundational architecture and creates technical alignments for the full solution balancing the needs from both business and domain architecture. Has an expert knowledge of integration solutions and communicates with business owners, domain architects, other Solution Architects, technical delivery staff, and key technical stakeholders, including Security, Data, and Technology Centers of Excellence. Collaborates with peer Solution Architects to ensure that the proposed solution is consistent with other designs.

Leads Solutions Design and Analysis:

  • Leads solutions design incremental and analysis of complex projects/issues that require in-depth knowledge across multiple technical areas and business segments. Responsible for defining components and subsystem, end to end integration architecture and their interface, as well as the target deployment aligning with target architecture vision. Responsible for recommendations of critical design decisions and trade-offs. Ensures seamless integration of new applications with enterprise applications in the ecosystem by selecting the technology, tools or services that provides the best solution for business needs.  

Orchestrate solution delivery:

  • Accountable for communicating solution architecture and getting it implemented. Defines and directs implementation governance activities associated ensuing solution architecture compliance with the intent and overall enterprise architecture. Responsible for creates architecture and technical enablers to support architecture runways. Supports the implementation of enablers and ensures solution of technical and architecture enablers meet solution objectives.

Facilitate and collaborate to drive business value:

  • Partners with the project manager, product managers technical delivery manager, requirements manager, and business leadership in the definition of the Solution Architecture.Work closely with product managers, product owners to ensure a robust architecture runways that can support future business needs through product lifecycle. Provide consulting supports to domain architects and solution delivery team to ensure project and product aligned with overall enterprise architecture.

Maintain industry and technology Expertise:

  • Maintains knowledge of and apply industry best practices for architecture, participates in cross-functional component architecture teams, and develops future architecture and technology migration plans. Evaluates and selects from existing and emerging technologies options best fitting business and IT strategic needs.

SUPERVISORY RESPONSIBILITY:
Position does not have direct reports but is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources.
QUALIFICATIONS:
Education Level: Bachelor's Degree in Computer Science, IT related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
Experience: 10 years' experience as an infrastructure architect
Preferred Qualifications:

  • Bachelor's degree in computer science or related field preferred.  Experience in the development, implementation, and maintenance of large-scale systems, preferably across multiple hardware and software platforms (in the health care industry).  Experience with intranet development and implementation is a plus. 

Knowledge, Skills and Abilities (KSAs)

  • Proficiency in innovating ideas and solutions resulting in tangible and measurable business outcomes.
  • Mastery in creating architecture solutions within the enterprise architecture future state for technological acceleration of value outcomes, and effectively present and persuade key decision makers to invest in this acceleration. 
  • Must have recent solution/domain architecture experience with  Facets G6 real-time and batch claims processing, pre-adjudication validation, EDI-based transaction data management,  claim editing engines, and third-party integrations with partner organizations that provide these services.
  • Must have experience working with claims processing, enrollment, billing & payments, underwriting, partner programs, business operations, and benefit management business functions either in a commercial or government area (both preferred). 
  • Additional architecture experience in one or more technology platforms (Salesforce Health Cloud/Data Cloud, other Healthcare specific platforms, MuleSoft, Kafka, , Azure Fabric) 
  • Expertise with two or more architecture domains (enterprise architecture, solution architecture, software development, data, integration, interoperability, cloud, artificial intelligence) and their associated architecture frameworks, standards/patterns, methods and tools. Experience overseeing and driving third-party solution architecture engagements and outcomes.
  • Knowledge of healthcare data interchange standards (e.g., HL7, FHIR, X12) and regulatory requirements (HIPAA, CMS, NCQA).
  • Experience contributing to portfolio rationalization and/or technical debt remediation initiatives at an enterprise level
  • Ability to motivate and influence others so that architecture objectives are met in a timely and consistent manner           
  • Ability to collaborate with stakeholders to develop high quality, architecture solutions and technical designs based on approved standards. 
  • Ability to coach peers and team members across multiple business and technology disciplines. 
  • Ability to provide solution architectural consulting to business leaders, program leaders, product owners, and delivery teams
  • Ability to set architectural solutions across multiple initiatives or domains aligned to platform/product roadmaps and facilitate implementation of approved solution.              
  • Effective organizational/interpersonal/relationship management, analytical/systems thinking, communications (written and verbal) and collaboration across multiple business and IT teams.
  • Recent payer or provider healthcare experience a plus.

Salary Range: 155,600 - 278,135

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

#LI-LD1 

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