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Remote Claims Reviewer Jobs in Iowa (NOW HIRING)

Insurance Specialist (Remote)

Des Moines, IA ยท On-site +1

$17 - $19/hr

You will utilize your expertise in patient billing, claims submission, and payer guidelines ... For further information, please review the Know Your Rights notice from the Department of Labor.

Epic Denials Management Operator

Des Moines, IA ยท Remote

$17.50 - $23.50/hr

Review AR aging reports and work queues to identify unpaid and delayed claims. Follow up with third ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...

Epic Denials Management Operator

Davenport, IA ยท Remote

$17 - $22.75/hr

Review AR aging reports and work queues to identify unpaid and delayed claims. Follow up with third ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...

Senior Commercial Program Underwriter - Remote

Nevada, IA ยท Remote

$92K - $109K/yr

Directs cross-functional onboarding and go-live readiness across Underwriting, Actuarial, Claims ... Reviews and approves product structures, policy forms, endorsements, and material wording changes ...

$55K - $100K/yr

That's where you, our Sales Specialist (called a Protocol Review Specialist in our world), make the ... unsubstantiated claims. * Brand Integrity: We partner with brands that care about what their ...

Showing results 21-40

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:

Workers' Compensation Claims Specialist (REMOTE - MT, AZ, CO)

Creative Risk Solutions

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

$22.75 - $31.50/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 13 days ago


Job description

Job Description:

Step into a role where your client service expertise makes a meaningful impact. We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently-empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients.

Essential Responsibilities:

  • Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner.
  • Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims.
  • Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues.
  • Enters and maintains accurate information on a computer system during the claim process, to include final settlement information.
  • Generates checks for indemnity and medical payments daily.
  • Develops and monitors consistency in procedural matters of claims handling process within CRS.
  • Willingness to become licensed if required in jurisdiction where claims are handled.

Qualifications:

  • Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU.
  • Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling.
  • Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire.
  • Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs.
  • Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience.

Here's a little bit about us:

Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies.

In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members.

Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as:

  • Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey!
  • Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow.
  • 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for.
  • Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first.
  • Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you.
  • Inclusion & Belonging Programs - Holmes Murphy is committed to celebrating every employee's unique potential. Through inclusion and belonging initiatives, titled Uniquely United, not only do we offer employees a paid Diversity Day time-off option, but we also have a Uniquely United Committee, Employee Resource Groups, and development programs to advance our culture of belonging. We encourage employees to engage in ways that are meaningful to them to enhance their overall experience!
  • Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing.
  • Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?!

At this time, we are not considering candidates who require any type of immigration sponsorship now or in the future. This includes candidates whose current work authorization is temporary or set to expire and who would require employer participation in any renewal, extension, or new authorization process to continue employment.

The salary range for this role is $57,500- $98,900. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development.

Holmes Murphy & Associates is an Equal Opportunity Employer.

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