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Remote Claims Jobs in Rio Rancho, NM (NOW HIRING)

Workit Health

RCM Specialist

Albuquerque, NM · On-site +1

$18.75 - $25.75/hr

M-W in office and Th-F remote each week Job Summary: Workit Health is seeking a full-time RCM ... Identify and resolve claims processing issues, including pre-submission errors, and generate ...

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Showing results 1-20

All JobsClaims JobsRemote Claims JobsRemote Claims Jobs in Rio Rancho, NM

Remote Claims information

See Rio Rancho, NM salary details

$28.7K

$60.8K

$84.7K

How much do remote claims jobs pay per year?

As of Jul 19, 2026, the average yearly pay for remote claims in Rio Rancho, NM is $60,771.00, according to ZipRecruiter salary data. Most workers in this role earn between $48,000.00 and $71,000.00 per year, depending on experience, location, and employer.

What are some 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 are the key skills and qualifications needed to thrive as a Remote Claims Specialist, and why are they important?

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 remote claims jobs?

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 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 job categories do people searching Remote Claims jobs in Rio Rancho, NM look for? The top searched job categories for Remote Claims jobs in Rio Rancho, NM are:
What cities near Rio Rancho, NM are hiring for Remote Claims jobs? Cities near Rio Rancho, NM with the most Remote Claims job openings:
Remote Claims jobs near you
Infographic showing various Remote Claims job openings in Rio Rancho, NM as of July 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $60,771 per year, or $29.2 per hour.
AVP, Claims & Judi Strategy - Remote

AVP, Claims & Judi Strategy - Remote

Prime Therapeutics LLC

Albuquerque, NM • On-site, Remote

$164K - $279K/yr

Full-time

Posted 8 days ago

Prime Therapeutics rating

7.8

Company rating: 7.8 out of 10

Based on 47 frontline employees who took The Breakroom Quiz

15th of 104 rated pharmacies

Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting Title
AVP, Claims & Judi Strategy - RemoteJob Description
The AVP, Claims & Judi Strategy is responsible for defining and driving the enterprise vision and multi-year strategy for the claims block, ensuring alignment across key stakeholders. This role partners cross-functionally to identify improvement opportunities, set realistic delivery expectations, and lead large-scale initiatives that enhance claims capabilities, technology, and operational efficiency. This position oversees development and management of the business value case to support strategic investment in the roadmap.
Responsibilities
  • Define and lead the multi-year claims technology and capability strategy, including roadmap development for claims platforms, capacity planning, prioritization of enhancements, and assessment and sunsetting of claims-adjacent systems to reduce complexity and improve efficiency in partnership with key stakeholders
  • Lead and communicate the enterprise vision for claims block, ensuring alignment to roadmap across business units and active engagement with peer block owners to identify gaps, challenge existing processes, and drive continuous improvement across claims capabilities
  • Establish clear delivery boundaries and expectations in partnership with account management, aligning on client commitments and operational feasibility
  • Drive education, communication, and adoption strategies across business units and functional teams, including the development of business case vision and value for investment
  • Partner with Claims Operations, Configuration Operations, and Strategic Solutions teams to lead large-scale, high-impact initiatives that improve claims outcomes and business performance
  • Assess and manage external partner impacts and dependencies, ensuring alignment with organizational capabilities, contractual obligations, and long-term strategic goals
  • Remain aware of leading-practice industry technologies, including AI, and ensure future-state roadmaps responsibly include leading-edge technological capabilities
  • Other duties as assigned

Minimum Qualifications
  • Bachelor's degree in Business, Healthcare Administration or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma from an accredited school or GED is required
  • 12 years of work experience in project management, portfolio management or operations
  • 8 years of leadership/people management experience
  • Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications
  • Demonstrated ability to communicate effectively, both verbal and written, and the proven ability to work effectively with all organizational levels and external contacts
  • Strong strategic-thinking, analytic, and problem-solving skills
  • Excellent facilitation, presentation, and consultative skills; skilled at managing meetings and listening with the ability to interpret information into consistent and concise actions that drive results
  • Ability to effectively drive business and lead transformation in a dynamic and complex operating environment
  • Strong conflict management skills with ability to influence and drive stakeholders to most impactful outcomes
  • Understanding of adjudication engines and technical risk management

Preferred Qualifications
  • Master of Business Administration
  • Pharmacy Benefit Management or healthcare experience

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job
Potential pay for this position ranges from $164,000.00 - $279,000.00 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.

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About Prime Therapeutics

Sourced by ZipRecruiter

Prime Therapeutics, located in Eagan, MN, is a pharmacy benefits management company that has been serving the healthcare industry since its foundation. They are an integral participant in the medical sector, specifically in the realm of health insurance. They focus on providing innovative pharmacy benefits and services to more than 30 million members nationwide. Besides their main pharmacy benefit management, they offer mail service pharmacy, specialty pharmacy, benefits management, and consultative engagement services to ensure individuals have continuous access to affordable prescription drugs. Prime Therapeutics, founded around three decades ago, has grown to stand out as a leader in its industry, thanks to its commitment to improving the health of its clients.

Industry

Insurance services

Company size

1,001 - 5,000 Employees

Headquarters location

Eagan, MN, US

Year founded

1987

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