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Remote Claims Reviewer Jobs (NOW HIRING)

State of Wisconsin

Disability Claims Reviewer

Madison, WI · On-site +1

$72K/yr

The Disability Claims Reviewers will maintain the capability and flexibility to efficiently process ... Remote work flexibility will be discussed in more detail during the interview process. * DHS does ...

New

Lorven Technologies

Physician ED Claims Reviewer

Remote * Bachelor's degree in related field. * Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review of claims and UM ...

NTT DATA

Medical Claims Processor, Remote

$17.50 - $22/hr

Remote Claims Processing Associate NTT DATA is seeking to hire a Remote Claims Processing Associate ... Reviewing the policies and benefits * Complying with company regulations regarding HIPAA ...

NTT DATA

Healthcare Claims Processor, Remote

$17.50 - $22/hr

Remote Claims Processing Associate NTT DATA is seeking to hire a Remote Claims Processing Associate ... Reviewing the policies and benefits * Complying with company regulations regarding HIPAA ...

NTT DATA

Medical Claims Processor - Remote

$18/hr

Remote Claims Processing Associate NTT DATA is seeking to hire a Remote Claims Processing Associate ... Reviewing the policies and benefits * Complying with company regulations regarding HIPAA ...

Conduent, Inc.

Remote Claims Processing Clerk

KY · Remote

$15/hr

Remote Claims Processing Clerk Schedule: Monday- Friday 8:00 AM - clean desk (based on business ... Review emails and Microsoft Teams messages at the start of each shift * Log into internal systems ...

Bosun

Full-Service Restoration Reviewer

Jacksonville, FL · On-site +1

$67K - $70K/yr

... join their remote Claims Force team. As a Full-Service Reviewer, you will be responsible for reviewing estimates across a broad range of restoration service types -including mitigation ...

NTT DATA Services

Claims Examiner Remote

Plano, TX · On-site +1

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and ... Processing of Professional claim forms files by provider Reviewing the policies and benefits Comply ...

NTT DATA Services

Claims Examiner Remote

Plano, TX · On-site +1

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and ... Reviewing the policies and benefits • Comply with company regulations regarding HIPAA ...

NTT DATA Services

Claims Examiner Remote

Plano, TX · On-site +1

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and ... Reviewing the policies and benefits • Comply with company regulations regarding HIPAA ...

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Remote Claims Reviewer information

See salary details

$30.5K

$64.6K

$90K

How much do remote claims reviewer jobs pay per year?

As of Aug 30, 2026, the average yearly pay for remote claims reviewer in the United States is $64,609.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,000.00 and $75,500.00 per year, depending on experience, location, and employer.

What is a remote claims reviewer?

A Remote Claims Reviewer is a professional who evaluates and processes insurance claims from a remote location, rather than working onsite at an insurance company or healthcare provider. Their primary responsibilities include reviewing submitted claims for accuracy, completeness, and compliance with policy and regulatory guidelines. They may work with various types of claims, such as health, auto, or property insurance, and often use specialized software to assess documentation and make determinations. Remote Claims Reviewers communicate with claimants, providers, and other stakeholders to gather information and resolve issues. This role requires strong attention to detail, analytical skills, and a good understanding of insurance policies and procedures.

What are the key skills and qualifications needed to thrive as a remote claims reviewer?

To thrive as a Remote Claims Reviewer, you need a solid understanding of insurance policies, claims adjudication processes, and attention to detail, typically supported by experience in claims processing or a related field. Familiarity with claims management systems, electronic documentation, and industry certifications such as AIC (Associate in Claims) are commonly required. Excellent analytical skills, strong communication, and self-motivation are critical soft skills for effective remote work and accurate claim evaluations. These skills ensure claims are processed efficiently, accurately, and in compliance with regulations, maintaining trust and minimizing financial risk.

How do remote claims reviewers effectively collaborate with other team members while working from home?

Remote Claims Reviewers typically use a combination of secure communication platforms, such as email, video conferencing, and specialized claims management systems, to stay connected with their colleagues and supervisors. Regular virtual meetings, chat channels, and collaborative document tools help facilitate discussions about complex claims, share updates, and clarify procedures. While working remotely requires proactive communication, most companies provide structured workflows and support resources to ensure claims reviewers can easily reach out for guidance or escalate issues as needed.

What is the difference between Remote Claims Reviewer vs Remote Claims Processor?

AspectRemote Claims ReviewerRemote Claims Processor
Required CredentialsHigh school diploma or equivalent; insurance knowledge often preferredHigh school diploma or equivalent; basic insurance knowledge beneficial
Work EnvironmentHome-based, independent review settingHome-based, processing claims as assigned
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, healthcare providers
Common Search & ComparisonYesYes

The main difference is that Remote Claims Reviewers evaluate and verify claims for accuracy and compliance, often requiring insurance knowledge, while Remote Claims Processors handle the submission and initial processing of claims. Both roles are remote, industry-specific, and involve insurance-related tasks, but their focus and responsibilities differ.

More about Remote Claims Reviewer jobs

What cities are hiring for Remote Claims Reviewer jobs?

Cities with the most Remote Claims Reviewer job openings:

What are the most commonly searched types of Claims Reviewer jobs?

The most popular types of Claims Reviewer jobs are:

What states have the most Remote Claims Reviewer jobs?

States with the most job openings for Remote Claims Reviewer jobs include:

What job categories do people searching Remote Claims Reviewer jobs look for?

The top searched job categories for Remote Claims Reviewer jobs are:

Remote Claims Reviewer jobs near you
Infographic showing various Remote Claims Reviewer job openings in the United States as of August 2026, with employment types broken down into 1% Internship, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 82% Physical, 5% Hybrid, and 13% Remote job distribution, with an average salary of $64,609 per year, or $31.1 per hour.

Disability Claims Reviewer

State of Wisconsin

Madison, WI • On-site, Remote

$72K/yr

Full-time

Medical, Retirement, PTO

Posted 3 days ago

New

State Of Wisconsin rating

7.9

Company rating: 7.9 out of 10

Based on 130 frontline employees who took The Breakroom Quiz

17th of 50 rated states

Job description

Introduction
The Department of Health Services (DHS), Division of Medicaid Services is recruiting for multiple full-time and 2 part-time (32 hours per week) Disability Claims Reviewer in the Disability Determination Bureau.
The DDB consists of approximately 200 employees, including some contractors. The DDB operates on a yearly budget of approximately $30 million funded by the Social Security Administration (SSA) to do medical determinations for SSA disability claims. The DDB also processes a small number of State Medicaid disability claims funded by DHS. The DDB must follow all SSA policies and regulations for safety, security and hiring as well as State of Wisconsin policies and regulations.
As an employee of the State of Wisconsin, you'll have access to an amazing benefits package . Note: Benefits and leave time will be prorated based on the number of hours worked.
  • 3.5 weeks of vacation, 9 paid holidays and ample sick time ; limitations may apply for leave time usage in the first six months.
  • Top rated health plan options starting at $47/month for single plans and $117/month for family plans, after 2 months of state service.
  • Exceptional pension plan with a 7.2% employer match in 2026 with lifetime retirement payment. Plus, a tax advantaged supplemental retirement savings plan which allows you to save money directly from your paycheck for retirement. Use this Total Rewards Calculator to see the total value of our competitive benefits package!
  • Several flex spending accounts: medical, dependent care, commuter, parking and High-Deductible Health Savings.
  • Well Wisconsin Wellness Program.
  • A free and confidential employee assistance program that offers employees and their immediate family dependents a variety of tools, resources, and professional consultation services to support their health, goals, and overall well-being.
  • Public Service Loan Forgiveness Program employer.

These positions offer the option to work remotely up to 4 days per week after the completion of 3 months of training and is headquartered at 1400 E. Washington Avenue office in downtown Madison and offers free on-site parking. This schedule may vary based on training or operational need.
Position Summary
These positions decide and document disability entitlement under the Social Security Disability Act, Amendments, and Regulations in both paper and electronic formats. This requires:
  • Extensive reading of records.
  • Working with electronic medical, vocational, and other records pertaining to disability.
  • Effective caseload management in an electronic environment.
  • High case production and decisional accuracy which requires timeliness of decisions.
Based on Agency workload needs and guided by the Social Security Administration, the Disability Claims Reviewers evaluate a mix of Adult, Child and Continuing Disability Review claims at both the initial and appellate levels under Title II, Title XVI, and Title XIX of the Social Security Act. Workloads may vary over time and by section or work unit. The Disability Claims Reviewers will maintain the capability and flexibility to efficiently process a variety of disability claim types.
Salary Information
The starting pay is between $35.00 and $37.68 per hour (approximately between $72,800 and 78,300 per year), depending on qualifications, plus excellent benefits. A 12-month probationary period is required.
Pay for current or former state employees will be set based on the rules that apply to compensation for the applicable transaction The position is classified as Disability Claims Reviewer and is in pay schedule and range 12/64.
Job Details
  • All applicants who may be appointed to these positions will be required to go through a complete federal background investigation. A suitability determination by the Social Security Administration is necessary prior to hire to determine whether an employee can be issued credentials in order to have access to Social Security disability data, records, and systems.
  • For positions that allow remote working flexibility, working outside of Wisconsin or in bordering cities will not be allowed except in extremely limited circumstances due to the need to report to an office location in Wisconsin on short notice.
  • Employees must have access to both a private workspace and secure high-speed internet for remote work option. Mileage reimbursement to the employee's headquarter location is not provided. Remote work flexibility will be discussed in more detail during the interview process.
  • DHS does not sponsor work visas for these positions, thus, in compliance with federal law, selected candidates will be required to verify eligibility to work in the United States by completing the require d I-9 form upon hire. DHS is not an E-Verify employer nor a STEM-OPT eligible employer.

Qualifications
Minimally qualified applicants will have all of the following:
  • Experience evaluating and adjudicating and making medical determinations on Social Security and Medicaid disability claims using knowledge of initial T-2, T-16 and T-19 disability claims of the Social Security Act and Amendments.
  • Experience independently resolving complex policy questions using a variety of resources including policy resources, business process documents, training manuals or in-house consultants.
  • Experience using medical terminology in a work setting.
  • Experience providing technical assistance to internal and external customers in a professional setting (e.g., answering questions, explaining requirements to customers, etc.)
Well-qualified applicants will also have one or more of the following:
  • 18 or more months of experience adjudicating disability claims in a state disability office.
  • Experience adjudicating Reconsideration or Quick Disability Determination/Compassionate Allowance claims.
Your letter of qualifications is limited to 1 page and your resume is limited to 2 pages. For a guide on developing your resume and letter of qualifications and what should be included in these materials, click here .
How To Apply
Applying is easy! Click "Apply for Job" to start your application process. Sign into your account or create an account before applying for the job. Follow the steps outlined in the application process to submit your application.
Helpful Information:
  • Once your application is submitted, no changes are allowed. Click "Save" to allow changes to your application as needed before submitting by the deadline.
  • You may want to save a copy of the job posting for referencing after the deadline.
  • Submitted materials will be evaluated by a panel of job experts according to the qualifications above.
  • Please monitor your email for communications related to this position.
  • Current or former permanent, classified, state employees must complete the online application process to be considered.
  • If viewing through an external site, please apply directly at Wisc.Jobs .
  • For technical assistance and general information, please see Frequently Asked Questions . For questions about the position, to request a copy of the full position description, or for other employment inquiries, please contact DDB Human Resources at DHSBHRDDB@dhs.wisconsin.gov
DHS is an Equal Opportunity and Affirmative Action employer. Veterans are encouraged to apply. For complete information on Veterans' hiring programs with the WI Department of Veteran's Affairs, click here .
Deadline to Apply
The deadline to apply is September 1, 2026 by 11:59 pm.
Applicants are strongly encouraged to allow ample time to finalize their applications keeping in mind that technical assistance is only available Monday through Friday 7:45 am - 4:30 pm. Late or incomplete applications will not be accepted.

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