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

Apex Systems

Python Engineer-AI

Woonsocket, RI · Remote

REMOTE Role Overview We are seeking a Python Engineer with a focus on data engineering. This role ... Work with large volumes of transactional and claims data, performing necessary aggregations.

Lantern

Strategy Analyst

Worcester, MA · Remote

... process. Job Overview The Strategy Analyst / Associate is a high-visibility, hands-on, and dynamic ... This is a remote-first role with occasional (~1x month) travel. Responsibilities and Duties:

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All JobsClaims Processor JobsRemote Claims Processor JobsRemote Claims Processor Jobs in Webster, MA

Remote Claims Processor information

See Webster, MA salary details

$12

$19

$27

How much do remote claims processor jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for remote claims processor in Webster, MA is $19.84, according to ZipRecruiter salary data. Most workers in this role earn between $16.92 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 cities near Webster, MA are hiring for Remote Claims Processor jobs? Cities near Webster, MA with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you

Business Analyst III as 100% Remote

Amicis Global

Woonsocket, RI • Remote

$51/hr

Contractor

Posted 22 days ago

Job description

Job Title: Business Analyst III
Location: Remote
Duration: 05 Months
 
Pay Rate: $45.00 - $50.00/- on W2
 
 
Kindly share your most updated resume.
 
 
Roles and Responsibilities:
The Technical Medicaid Business Analyst serves as a critical bridge between Medicaid business operations and technical delivery teams. This role is responsible for translating federal and state Medicaid requirements, health plan business needs, and operational workflows into detailed functional requirements that support system configuration, data integration, reporting, and compliance. The analyst partners closely with business stakeholders, IT teams, vendors, and external partners to ensure Medicaid systems and solutions meet contractual, regulatory, and operational expectations.
Medicaid Business & Regulatory Analysis
Analyze federal and state Medicaid regulations, contract requirements, and policy guidance and translate them into clear business and functional requirements.
Support Medicaid program areas such as eligibility, enrollment, claims, encounters, care management, provider management, quality, and compliance.
Interpret CMS, state agency, and contractual changes and assess operational and system impacts.
Technical Requirements & Solution Design
Develop detailed functional and technical requirements, including use cases, process flows, data mappings, interface specifications, and system configuration needs.
Collaborate with IT, data, and vendor teams to design and validate technical solutions that align with Medicaid business needs.
Support system enhancements, defect resolution, and new implementations across core Medicaid platforms (e.g., claims, encounters, care management, data warehouse).
Data & Integration Support
Analyze data flows between Medicaid systems, vendors, and external entities (state agencies, CMS, providers).
Support reporting, analytics, and regulatory submissions (e.g., encounter data, quality measures, financial reporting).
Assist with data validation, reconciliation, and root‑cause analysis for Medicaid data issues.
Stakeholder & Cross‑Functional Collaboration
Serve as a liaison between Medicaid business teams, IT, finance, compliance, and external vendors.
Facilitate requirements workshops, design sessions, and stakeholder reviews.
Clearly communicate complex technical concepts to non‑technical stakeholders and business priorities to technical teams.
Testing & Implementation Support
Support system testing activities, including test planning, test case development, and user acceptance testing (UAT).
Validate that solutions meet Medicaid business and regulatory requirements prior to deployment.
Support go‑live activities and post‑implementation issue resolution.
Documentation & Governance
Maintain clear, audit‑ready documentation of requirements, decisions, and approvals.
Ensure alignment with Medicaid governance, SDLC, and change management processes.
Support audits, regulatory reviews, and compliance inquiries as needed.
REQUIREMENTS
Experience in business operations, with the ability to understand and address complex business challenges.
Strong verbal and written communication skills, with a demonstrated ability to explain complex topics to diverse audiences.
Proven ability to collaborate effectively with both business units and IT teams, acting as a bridge between technical and non‑technical stakeholders.
Experience translating business needs into clear, actionable inputs for technical partners.
Bachelor’s degree in Business, Information Systems, Health Administration, Public Health, or a related field (or equivalent experience).
5+ years of experience as a Business Analyst, with direct Medicaid or healthcare payer experience.
Strong understanding of Medicaid programs, managed care operations, and state/federal compliance requirements.
Experience translating business requirements into technical specifications.
Experience working with IT teams, system vendors, and data/reporting teams.
Strong analytical, documentation, and problem‑solving skills.
 
Preferred Qualifications
Experience supporting Medicaid managed care organizations (MCOs) or state Medicaid programs.
Familiarity with Medicaid healthcare payer systems such as claims platforms, encounter processing, care management systems, or eligibility/enrollment platforms.
Experience with data analysis, SQL, or data warehouse concepts.
Knowledge of CMS reporting, state encounter submissions, or quality programs.
Experience with Agile, SAFe, or traditional SDLC methodologies.
 
Core Competencies
Medicaid subject matter expertise
Technical and systems thinking
Requirements elicitation and documentation
Data analysis and validation
Stakeholder communication
Regulatory and compliance awareness
Attention to detail and audit readiness
 
 
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