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Remote Claims Reviewer Jobs in Raleigh, NC (NOW HIRING)

Iatinsurancegroup

Claims Major Case Director

Raleigh, NC · On-site +1

$92K - $130K/yr

... remote arrangements for the ideal candidate. This role is a true complex claims handling role that ... reviewing and analyzing reports and related bills. * Identifies and addresses subrogation ...

Deloitte

Accounts Receivable Analyst

Raleigh, NC · Remote

$23.25 - $29.75/hr

... remote client service delivery. Recruiting for this role ends on 08/01/2026 Work you'll do As an ... Review AR aging reports and work queues to identify unpaid and delayed claims. * Follow up with ...

Deloitte

Hospital Billing Coordinator

Raleigh, NC · Remote

$50K - $60K/yr

As an Epic Hospital Billing Coordinator, you will help review and submit hospital claims, resolve billing issues, and work across teams to reduce avoidable denials. This is a primarily remote role ...

Deloitte

Hospital Billing Operator

Raleigh, NC · Remote

$17.75 - $22.75/hr

As an Epic Hospital Billing Analyst, you will help review and submit hospital claims, resolve billing issues, and work across teams to reduce avoidable denials. This is a primarily remote role ...

TEKsystems

Project Manager

Raleigh, NC · Remote

$50 - $65/hr

... Remote work permitted. This position will allocate approximately 50% of its effort supporting Medicaid claims data initiatives and 50% supporting State Health Plan claims data initiatives. The ...

Atlantic Medical Management

RCM Coder

Cary, NC · Remote

$17.25 - $23.25/hr

This is a remote position and candidates must be located in North Carolina. Essential Functions ... Reviews and verifies documentation supports diagnoses, procedures, and treatment results.

AMM Healthcare

RCM Coder

Cary, NC · Remote

$17.25 - $23.25/hr

This is a remote position and candidates must be located in North Carolina. Essential Functions ... Reviews and verifies documentation supports diagnoses, procedures, and treatment results.

EmergeOrtho

Accounts Receivable Specialist

Durham, NC · On-site +1

$18.25 - $24.25/hr

This includes creating claims according to regulations and compliance guidelines, patient account ... Remote Work Environment - Work comfortably from home while staying connected to a dedicated and ...

New

Oshi Health

Accounts Receivable Specialist

Raleigh, NC · Remote

$19.75 - $26/hr

Investigate and resolve claim denials by submitting corrected claims, appeals, reconsiderations ... Review claim edits and rejections to ensure accurate resubmission and minimize future denials.

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All JobsClaims Reviewer JobsRemote Claims Reviewer JobsRemote Claims Reviewer Jobs in Raleigh, NC

Remote Claims Reviewer information

See Raleigh, NC salary details

$29.6K

$62.8K

$87.5K

How much do remote claims reviewer jobs pay per year?

As of Jul 26, 2026, the average yearly pay for remote claims reviewer in Raleigh, NC is $62,805.00, according to ZipRecruiter salary data. Most workers in this role earn between $49,600.00 and $73,400.00 per year, depending on experience, location, and employer.

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 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, and why are they important?

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.

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 Raleigh, NC? The most popular types of Claims Reviewer jobs in Raleigh, NC are:
What are popular job titles related to Remote Claims Reviewer jobs in Raleigh, NC? For Remote Claims Reviewer jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Remote Claims Reviewer jobs in Raleigh, NC look for? The top searched job categories for Remote Claims Reviewer jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Claims Reviewer jobs? Cities near Raleigh, NC with the most Remote Claims Reviewer job openings:
Remote Claims Reviewer jobs near you
Infographic showing various Remote Claims Reviewer job openings in Raleigh, NC as of June 2026, with employment types broken down into 2% Locum Tenens, 46% Full Time, 37% Part Time, 5% Temporary, and 10% Contract. Highlights an 38% Physical, 3% Hybrid, and 59% Remote job distribution, with an average salary of $62,805 per year, or $30.2 per hour.

Claims Processor Self-Funded

Marpai Administrators LLC

Cary, NC • Remote

$24 - $30/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 29 days ago

Job description

Marpai Administrators is a technology company transforming the Third-Party Administration sector serving employers with self-funded health plans. Marpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. We create healthier members and a healthier bottom line. Marpai proactively targets at-risk members with meaningful clinical interventions to improve outcomes. 
ABOUT THE POSITION:
The Claims Processor will be responsible to for reviewing claims for accuracy, completeness, and eligibility. The Claims Processor is responsible to adjudicate claims, complete work assignments and meet established departmental metrics.  
WHAT YOU WILL BE DOING: 
  • Data entry of claims into system. 
  • Review, analyze adjudicate claims 
  • Validate the information on all claims to ensure there is no missing or incomplete information
  • Ability to understand and apply benefits as outlined in plan document
  • Maintain/manage all claim inventories in accordance with health plan and regulatory policies
  • Display maturity, composure and ability to operate under stressful conditions.
  • Complete daily assignments and update required spreadsheet
  • Complete end of day summary
  • Flexibility to change work direction as determined by management
  • Meet departmental standards for quality, production and attendance. 
  • Analyst is flexible and able to commit to overtime based on business needs 
  • Other duties as required
 
WHAT DO YOU NEED 
  • Associates degree preferred
  • 2+ yrs claims processing self-funded claims
  • Strong analytical, research, and communication skills.
  • Expansive knowledge of medical terminology.
  • Excellent verbal and written communication skills as well as exemplary organizational skills.
  • Work closely with leadership to assist in mitigating trends as necessary.
  • Independent judgment in decision-making and problem solving.
  • Computer skills in MS Word, Excel, PowerPoint, & Outlook at the intermediate or higher level.
  • Ability to multi-task & anticipate potential needs/problems.
  • Strong attention to detail.
  • Ability to understand and apply on-line documentation policies and procedures.
  • Excellent customer services skills including an ability to follow through, take ownership and drive all assigned tasks to completion.
  • Ability to handle large volumes of work, solve problems and manage multiple assignments while meeting critical deadlines.
  • HIPAA Compliance
 
WORK REQUIREMENTS:
  • Fast paced, dynamic work environment requiring the ability to be adaptive, innovative and flexible
  • Travel minimal
 
WHY WORK AT MARPAI?  
We have great benefits: 
  • Generous PTO
  • Medical and Prescription 
  • EAP 
  • FSA / HSA / Dependent Care
  • Dental 
  • Vision 
  • Life and Disability 
  • STD/LTD
  • Voluntary Benefits: Critical Illness, Accident, Hospital
  • 401k with Employer Match
  • LegalShield
  • Identity Theft Protection
 
Marpai is an equal opportunity workplace.  We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.

This is a remote position.