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Remote Claims Reviewer Jobs in Iowa (NOW HIRING)

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Remote Claims Reviewer information

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.

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

The most popular types of Claims Reviewer jobs in Iowa are:

What cities in Iowa are hiring for Remote Claims Reviewer jobs?

Cities in Iowa with the most Remote Claims Reviewer job openings:

Claims Attorney I

Merchants Bonding Company

West Des Moines, IA โ€ข On-site, Remote

Full-time

Medical, PTO

Posted 4 days ago


Job description

Job Purpose:

  • The Claims Attorney I position is responsible to investigate and adjust claims made on commercial and contract surety bonds and E&O policies, communicate orally and in writing with various stakeholders, and pursue appropriate salvage and indemnity.ย  The Claims Attorney I works independently and with oversight from department leaders.ย  This role coordinates payment of loss and expense checks, sets and revises reserves, and prepares closing file documentation.ย  The Claims Attorney I must stay current on applicable State and Federal laws and regulations that apply to handling bond or E&O claims.ย 

Job Responsibilities:

Claim Investigation and Loss Analysis

  • Reviews and analyzes correspondence and documents primarily submitted by claimants and Principals, interviews involved persons, and requests additional documentation in order to determine exposure.
  • Documents investigation efforts in the claim file and maintain relevant file documentation within Sims file.
  • Works with the Director of Claims to direct and oversee outside counsel and consultants as necessary to assist with claim investigation or salvage and indemnity aspect of claim.
  • Evaluates potential sources of salvage, reimbursement, and indemnification for any loss or expense that may be paid.ย  Requests recovery of loss, expenses, and costs in accordance with the terms of the Indemnity Agreement or the suretyโ€™s statutory or common law equitable rights or rights of equitable subrogation.
  • If necessary, and with the assistance of the Director of Claims/VP Claims, negotiate with stakeholders to resolve claims, including creating secured repayment plans, referrals to collection agencies, or pursuing indemnity actions.ย ย ย 
  • Drafts determination letters and reviews recommendations with supervisor, as required.ย  Prepares documentation for payments, if approved.ย 
  • Make decisions regarding collateral or other indemnity or subrogation rights with the assistance of the Director of Claims.ย  Obtains reimbursement pursuant to agreement such as collateral trust agreements.ย 

Research and Consultation

  • Works with the Director of Claims to seek legal counsel or retain consultants as appropriate based on the merits of the claims. Audits outcomes and performance to assure competence.ย  Reviews bills for accuracy and reasonableness.ย  Authorizes payment.ย 
  • Stays abreast of claims handling requirements of corresponding jurisdictions and attends required claim and anti-fraud training.ย 
  • Reviews bond language, contracts, codes, statutes, and case law, as applicable to the claims.

Reporting

  • Prepares year end reports, as required, for files by reviewing: status of open claims, Principalโ€™s financial condition, and evaluating accounts for necessary reserve changes.ย 
  • Prepares closing memorandums summarizing the claim issues and resolution, as well as losses incurred and salvage recovered.ย 
  • Prepare claim summaries or other reports for the Compliance Department as necessary.

Education and Experience:

  • J.D. required plus 2-4 years of experience in the Surety, Insurance, or related industry.ย  Experience investigating and adjudicating claims in the surety industry is preferred. License to practice law in appropriate jurisdictions.ย 

BENEFITS AT MERCHANTS

At Merchants, we value balancing the needs of our associates and their families. We're proud to offer a wide range of benefits designed to help you achieve a healthy work-life balance and support your personal and professional growth. In addition to competitive pay, bonus programs, and paid-time off, here are just a few of the amazing benefits:

  • Flexible hybrid and remote opportunities with 37.5 hour work week
  • Free health insurance option
  • Paid volunteer time off with matching gift program
  • Infants in the Workplace Program with family resources
  • Discover more benefits atย https://www.merchantsbonding.com/careers#nav-link-3

MERCHANTS BONDING COMPANY

Join the Merchants team and experience the difference of working for a surety-only company. At Merchants, we believe in the power of collaboration and teamwork, and we're committed to the success of our associates and customers by creating an inclusive culture that sets us apart and drives our success.

Our company is built on a foundation of providing common sense solutions and first-class experiences. From underwriting to claims and technology to marketing, every department and team collaborates together to achieve our common goal to be the most trusted team in surety.

Learn more about building your career at Merchants by visitingย www.merchantsbonding.com/careers.