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Remote Claims Jobs in Bayamon, PR (NOW HIRING)

Oversight and management of claims and denials management follow-up operations. Analyzes, plans and ... This is a remote role with minimal travel requirements. A successful candidate would possess these ...

Epic Denials Management Operator

San Juan, PR · Remote

$17.75 - $23.50/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 ...

Remote Claims information

See Bayamon, PR salary details

$27.5K

$58.2K

$81.1K

How much do remote claims jobs pay per year?

As of Sep 7, 2026, the average yearly pay for remote claims in Bayamon, PR is $58,197.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,900.00 and $68,000.00 per year, depending on experience, location, and employer.

What is a remote claims job?

Remote claims jobs involve evaluating, processing, and managing insurance claims from a remote location, typically from home. Professionals in these roles review claims submitted by clients, investigate the details, and determine the coverage or payment amounts according to company policies and regulations. These positions require strong analytical, communication, and organizational skills, along with a good understanding of insurance processes. Many insurance companies now offer remote claims roles, providing flexibility and work-from-home opportunities.

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

To thrive as a Remote Claims Specialist, you need a solid background in insurance processes, claims assessment, and a relevant educational qualification such as a degree in business or insurance. Familiarity with claims management software, CRM systems, and sometimes industry certifications like AIC (Associate in Claims) are commonly required. Strong attention to detail, effective communication, and self-motivation are crucial soft skills for managing cases independently and supporting clients remotely. These abilities ensure accurate, timely processing of claims and high levels of customer satisfaction in a virtual work environment.

What are common challenges faced by remote claims professionals, and how can they be managed?

Remote claims professionals often encounter challenges such as maintaining effective communication with team members and clients, managing time independently, and ensuring data security while handling sensitive information from home. To address these, it’s important to utilize collaboration tools, set structured work hours, and follow strict company protocols for cybersecurity. Regular virtual meetings and clear documentation can help maintain workflow efficiency and keep everyone aligned.

What is the difference between Remote Claims vs Remote Claims Adjuster?

AspectRemote ClaimsRemote Claims Adjuster
Required CredentialsVaries by role, often includes insurance knowledgeLicenses often required, such as state-specific adjuster licenses
Work EnvironmentRemote, office, or hybridPrimarily remote, with some fieldwork possible
Industry UsageInsurance companies, third-party administratorsInsurance companies, claims management firms
Common Search IntentGeneral claims roles, customer service, claims processingClaims evaluation, damage assessment, settlement

Remote Claims roles encompass a broad range of insurance-related positions, including claims processing and customer service, often without requiring specific licenses. Remote Claims Adjusters focus on evaluating claims, assessing damages, and may need state licenses. Both roles are remote-friendly and serve the insurance industry, but adjusters typically have more specialized credentials and responsibilities.

What are the most commonly searched types of Claims jobs in Bayamon, PR?

The most popular types of Claims jobs in Bayamon, PR are:

What cities near Bayamon, PR are hiring for Remote Claims jobs?

Cities near Bayamon, PR with the most Remote Claims job openings:

Infographic showing various Remote Claims job openings in Bayamon, PR as of August 2026, with employment types broken down into 89% Full Time, 8% Part Time, and 3% Contract. Highlights an 85% Physical, 4% Hybrid, and 11% Remote job distribution, with an average salary of $58,197 per year, or $28 per hour.

Epic Denials Manager

Deloitte

San Juan, PR • Remote

Full-time

Posted 13 days ago


Deloitte rating

8.2

Company rating: 8.2 out of 10

Based on 93 frontline employees who took The Breakroom Quiz

48th of 154 rated financial services


Job description

Epic Denials Manager

Position Summary

Join Deloitte's AI & Engineering practice to support hospital billing operations in a role focused on claim accuracy, timely reimbursement, and revenue cycle performance. As an Epic Denials Manager, you will help deliver back-end revenue cycle management (RCM) services, including denials and claims submission, denials management, payment posting, and credits and refunds, A/R follow-up for health care provider client.

Recruiting for this role ends on 10/01/2026.

Work you'll do

Epic Denials Manager on the AI & Engineering team, you will be responsible for the following areas. Oversight and management of claims and denials management follow-up operations. Analyzes, plans and implements organizational systems and processes, and makes recommendations for improvements in hospital denials, claims submission, and A/R follow-up operations. Leads activities related to operational analysis, financial analysis and process improvement initiatives. Maintains knowledge base of operational SOPs and workflows for relevant functional areas. Manages staff and employee performance, provides feedback, and leads training, education, and performance improvement activities for staff as required. Works closely with Manager of Billing and engagement leadership to resolve barriers to account and claim processing and identify and implement opportunity areas to remediate issues and improve workflows. Serves as line of escalation for high priority, complex accounts to be worked, including interactions with third party payers and client stakeholders as necessary to process accounts and claims. Regularly monitors work queues and workflows in Epic, claims clearinghouse, and other relevant technology systems. Collaborates closely with client managers and directors to ensure continuous open communication about hospital operations that impact delivery of services. Works with client team to develop and implement action plan to address trends as appropriate

Keeps current on insurance regulations, managed care contracts billing regulations, coding and fee schedules. Proactively manages access scorecards including user quality, productivity and team performance compared to Key Performance indicators and Service Level Agreements. This is a remote role with minimal travel requirements. A successful candidate would possess these skills:

  • Ability to work independently and collaborate as part of a team
  • Effective written and verbal communication skills
  • Meticulous attention to detail and quality of work product
  • Ability to build and sustain professional relationships
  • Ability to lead projects or workstreams
  • Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
  • Strong interpersonal skills and professional demeanor
  • Ability to meet deadlines

The team

AI & Engineering leverages cutting-edge engineering capabilities to build, deploy, and operate integrated/verticalized sector solutions in software, data, AI, network, and hybrid cloud infrastructure. These solutions are powered by engineering for business advantage, transforming mission-critical operations. We enable clients to stay ahead with the latest advancements by transforming engineering teams and modernizing technology & data platforms. Our delivery models are tailored to meet each client's unique requirements. Our Industry Solutions offering provides verticalized solutions that transform how clients sell products, deliver services, generate growth, and execute mission-critical operations. We deliver integrated business expertise with scalable, repeatable technology solutions specifically engineered for each sector.

Qualifications

Required:

  • 6+ years of experience as a Manager or Senior in processing and resolving third party payer denials, including technical and clinical denials, for hospital/acute facility services
  • 3+ years experience in denials resolution for both commercial and government payers
  • Experience leading team of 10+ staff to exceed productivity, quality, and service targets
  • Proficient in Epic Resolute Hospital Billing application
  • Proficient in Epic Analytics and Reporting applications (e.g., SlicerDicer)
  • Bachelor's degree, preferably in information technology, business, or healthcare related field; or equivalent experience
  • Limited immigration sponsorship may be available
  • Ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve
  • Role is remote

Preferred:

  • Experience using Microsoft Word, Excel, and PowerPoint
  • Experience supporting clinical or healthcare business operations
  • Experience preparing and delivering technical demonstrations
  • Experience analyzing denials workflows, claim issues, or operational data

The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $140,000 to $160,000 with overtime pay possible. 

You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.


Qualifications:

Epic Denials Manager

Position Summary

Join Deloitte's AI & Engineering practice to support hospital billing operations in a role focused on claim accuracy, timely reimbursement, and revenue cycle performance. As an Epic Denials Manager, you will help deliver back-end revenue cycle management (RCM) services, including denials and claims submission, denials management, payment posting, and credits and refunds, A/R follow-up for health care provider client.

Recruiting for this role ends on 10/01/2026.

Work you'll do

Epic Denials Manager on the AI & Engineering team, you will be responsible for the following areas. Oversight and management of claims and denials management follow-up operations. Analyzes, plans and implements organizational systems and processes, and makes recommendations for improvements in hospital denials, claims submission, and A/R follow-up operations. Leads activities related to operational analysis, financial analysis and process improvement initiatives. Maintains knowledge base of operational SOPs and workflows for relevant functional areas. Manages staff and employee performance, provides feedback, and leads training, education, and performance improvement activities for staff as required. Works closely with Manager of Billing and engagement leadership to resolve barriers to account and claim processing and identify and implement opportunity areas to remediate issues and improve workflows. Serves as line of escalation for high priority, complex accounts to be worked, including interactions with third party payers and client stakeholders as necessary to process accounts and claims. Regularly monitors work queues and workflows in Epic, claims clearinghouse, and other relevant technology systems. Collaborates closely with client managers and directors to ensure continuous open communication about hospital operations that impact delivery of services. Works with client team to develop and implement action plan to address trends as appropriate

Keeps current on insurance regulations, managed care contracts billing regulations, coding and fee schedules. Proactively manages access scorecards including user quality, productivity and team performance compared to Key Performance indicators and Service Level Agreements. This is a remote role with minimal travel requirements. A successful candidate would possess these skills:

  • Ability to work independently and collaborate as part of a team
  • Effective written and verbal communication skills
  • Meticulous attention to detail and quality of work product
  • Ability to build and sustain professional relationships
  • Ability to lead projects or workstreams
  • Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
  • Strong interpersonal skills and professional demeanor
  • Ability to meet deadlines

The team

AI & Engineering leverages cutting-edge engineering capabilities to build, deploy, and operate integrated/verticalized sector solutions in software, data, AI, network, and hybrid cloud infrastructure. These solutions are powered by engineering for business advantage, transforming mission-critical operations. We enable clients to stay ahead with the latest advancements by transforming engineering teams and modernizing technology & data platforms. Our delivery models are tailored to meet each client's unique requirements. Our Industry Solutions offering provides verticalized solutions that transform how clients sell products, deliver services, generate growth, and execute mission-critical operations. We deliver integrated business expertise with scalable, repeatable technology solutions specifically engineered for each sector.

Qualifications

Required:

  • 6+ years of experience as a Manager or Senior in processing and resolving third party payer denials, including technical and clinical denials, for hospital/acute facility services
  • 3+ years experience in denials resolution for both commercial and government payers
  • Experience leading team of 10+ staff to exceed productivity, quality, and service targets
  • Proficient in Epic Resolute Hospital Billing application
  • Proficient in Epic Analytics and Reporting applications (e.g., SlicerDicer)
  • Bachelor's degree, preferably in information technology, business, or healthcare related field; or equivalent experience
  • Limited immigration sponsorship may be available
  • Ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve
  • Role is remote

Preferred:

  • Experience using Microsoft Word, Excel, and PowerPoint
  • Experience supporting clinical or healthcare business operations
  • Experience preparing and delivering technical demonstrations
  • Experience analyzing denials workflows, claim issues, or operational data

The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $140,000 to $160,000 with overtime pay possible. 

You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.


Education:Bachelor's DegreeEmployment Type:

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