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Remote Claims Trainee Jobs in O Fallon, IL (NOW HIRING)

Deloitte

Epic Denials Management Operator

Saint Louis, MO · Remote

$17.50 - $23.25/hr

... Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for health care provider client. This is a primarily remote role supporting enterprise Epic support ...

Workforce Connections

Denials Specialist

Saint Louis, MO · Remote

$23/hr

Fully Remote Remote (preferred states): Missouri, Texas, Florida, Minnesota, Illinois, Georgia ... Familiarity with claims, correspondence, or appeals management systems * Experience working in a ...

All JobsClaims JobsRemote Claims Trainee JobsRemote Claims Trainee Jobs in O'Fallon, IL

Remote Claims Trainee information

What is a remote claims trainee?

Remote Claims Trainees are entry-level professionals who work from home or another remote location to learn how to evaluate and process insurance claims. They receive training on company policies, claims investigation, documentation, and customer service. During their training period, they work closely with experienced claims adjusters or supervisors to develop the skills needed to handle claims independently. This role is ideal for individuals seeking to start a career in insurance without needing to work in a traditional office setting.

What skills and qualifications are needed to thrive as a remote claims trainee?

To thrive as a Remote Claims Trainee, you need a basic understanding of insurance principles, strong analytical skills, and at least a high school diploma or relevant degree. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are beneficial. Excellent communication, organizational skills, and the ability to work independently are crucial soft skills for excelling remotely. These skills are important to ensure accurate claims processing, effective customer service, and smooth collaboration with team members from a distance.

How does a remote claims trainee typically collaborate with team members and supervisors while working from home?

As a Remote Claims Trainee, you'll often communicate with your team through video calls, chat platforms, and project management tools. You'll participate in regular virtual meetings for training, case discussions, and feedback sessions with supervisors. Collaboration is encouraged—trainees are usually paired with mentors or experienced adjusters who provide guidance and answer questions. While remote, you'll have access to digital resources and real-time support, ensuring you can learn processes and company standards efficiently. Staying proactive in communication helps foster a sense of teamwork and support, even when working independently.

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

AspectRemote Claims TraineeRemote Claims Processor
Required CredentialsHigh school diploma or equivalent; some roles may prefer related courseworkHigh school diploma or equivalent; relevant certifications optional
Work EnvironmentTraining period, supervised, learning-focusedFull-time, independent, task-oriented
Employer & Industry UsageInsurance companies, healthcare providers, government agenciesInsurance companies, third-party administrators, healthcare insurers

The main difference is that a Remote Claims Trainee is in a learning phase, focusing on training and skill development, while a Remote Claims Processor handles claims independently after training. Trainees are supervised and gaining experience, whereas processors are responsible for processing claims efficiently and accurately.

What are popular job titles related to Remote Claims Trainee jobs in O'Fallon, IL?

For Remote Claims Trainee jobs in O'Fallon, IL, the most frequently searched job titles are:

What job categories do people searching Remote Claims Trainee jobs in O'Fallon, IL look for?

The top searched job categories for Remote Claims Trainee jobs in O'Fallon, IL are:

What cities near O'Fallon, IL are hiring for Remote Claims Trainee jobs?

Cities near O'Fallon, IL with the most Remote Claims Trainee job openings:

Remote Claims Trainee jobs near you
Infographic showing various Remote Claims Trainee job openings in O'Fallon, IL as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Senior Claims Representative (Remote)

memployersmins

Kansas City, MO • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Job description

Are you a seasoned claims professional with a passion for navigating complex cases? MEM Insurance is seeking a Senior Claims Representative to join our Claims team. In this pivotal role, you’ll manage high-exposure workers’ compensation claims, lead investigations into coverage and fraud, and collaborate across departments to drive strategic outcomes. You’ll be a key decision-maker, a mentor to junior adjusters, and a champion of process improvement—all while ensuring exceptional service and regulatory compliance.
 
At MEM Insurance, we don’t just protect our customers—we empower our employees. We foster a culture of integrity, collaboration, and innovation. Our team thrives on solving challenges together, supporting one another, and making a meaningful impact in the lives of our policyholders and injured workers.
 
 
Essential Duties and Responsibilities:
Claims Handling & Administration
  • Manage highly complex claims involving significant financial exposure, legal intricacies, and extended life cycles.
  • Conduct advanced investigations into coverage and compensability, including nuanced statutory interpretations.
  • Oversee medical case management for catastrophic injuries and lifetime care needs.
  • Review and authorize large or complex medical bills, negotiating adjustments to control costs.
Return-to-Work Management
  • Develop comprehensive RTW strategies in collaboration with policyholders, legal counsel, and vocational consultants.
  • Ensure precision in benefit calculations for high-exposure claims, addressing tax and compliance risks.
  • Strategically deploy investigative efforts aligned with broader claims strategy.
Claims Investigation & Loss Prevention
  • Lead investigations into complex fraud cases and collaborate with the Special Investigations Unit.
  • Conduct subrogation analysis and negotiate with third-party insurers or attorneys for maximum recovery.
Settlements & Negotiation
  • Partner with legal teams to negotiate complex settlements and manage litigation processes.
  • Oversee Medicare compliance initiatives, including Medicare Set-Asides and CMS engagement.
  • Identify opportunities for structured settlements and lead negotiations.
Reporting
  • Produce strategic reports on high-profile claims to guide management decisions.
  • Maintain system data integrity and prepare claims for Corporate Plan of Action meetings.
Collaboration
  • Lead cross-departmental efforts to improve claims handling and risk management.
  • Resolve escalated customer service issues and support high-value accounts.
  • Participate in workflow improvement initiatives and committees.
Team Leadership
  • Mentor and coach junior and intermediate adjusters.
  • Review escalated claims and provide actionable feedback.
  • Support workforce development and succession planning.
 
Qualifications:
  • Bachelor’s degree in business or related field preferred, or equivalent industry experience.
  • 7–10 years of claims handling experience, with high exposure to Workers’ Compensation.
  • Associate in Claims (AIC), AIM, or CPCU designation preferred or ability to obtain.
  • Texas All-Lines license preferred.
  • Valid driver’s license required.
 
Company Culture and Values
At MEM Insurance, we are committed to our vision, mission, and values. We foster a culture of collaboration, integrity, and innovation. Our team is passionate about delivering exceptional service to our customers while supporting each other’s growth and success. We believe in accountability, continuous learning, and creating an environment where employees feel valued and empowered.
 
 Connection and Belonging
MEM Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that varied perspectives drive innovation and strengthen our ability to serve our customers and communities.
 
 Total Rewards Overview
  • Health Plans: Medical, Dental, and Vision
    Includes fertility benefits, fully paid preventative care, and adult orthodontia.
  • Employer-Paid Life and Disability Benefits:
    Life Insurance (3x base salary), AD&D, Short and Long-term Disability.
  • Wellness and Recognition Program: Employer-paid incentives for employees and spouses.
  • Flexible Spending Account and Dependent Care options
  • Health Savings Account: Generous employer contribution.
  • Time Away from Work:
    Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave.
  • Employee Assistance Programs
  • 401k Retirement Plan: Employer match and profit sharing.
  • Adoption Assistance and Tuition Assistance
 
Notice Regarding Use of Artificial Intelligence
MEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws.

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