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Remote Claims Jobs in Rochester, NY (NOW HIRING)

Kodak

Workers Compensation Manager

Rochester, NY · On-site +1

$85K - $100K/yr

Candidates seeking remote or hybrid work arrangements must have the ability and willingness to ... Ongoing communication for the purpose of claims investigations and strategy development with Kodak ...

Deloitte

Hospital Billing Analyst

Rochester, NY · Remote

$47.40K - $63.10K/yr

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 ...

Diedre Moire Corp.

Insurance Underwriter

Gates, NY · On-site +1

$100K - $300K/yr

REMOTE WORK FROM HOME POSSIBLE Seeking individual with extensive underwriting and program ... along with applicant claims history to determine plans, benefits, and rates. • Hands-on ...

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Remote Claims information

See Rochester, NY salary details

$29.5K

$62.5K

$87.1K

How much do remote claims jobs pay per year?

As of May 28, 2026, the average yearly pay for remote claims in Rochester, NY is $62,527.00, according to ZipRecruiter salary data. Most workers in this role earn between $49,400.00 and $73,100.00 per year, depending on experience, location, and employer.

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 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 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 are the most commonly searched types of Claims jobs in Rochester, NY? The most popular types of Claims jobs in Rochester, NY are:
What are popular job titles related to Remote Claims jobs in Rochester, NY? For Remote Claims jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Remote Claims jobs in Rochester, NY look for? The top searched job categories for Remote Claims jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Remote Claims jobs? Cities near Rochester, NY with the most Remote Claims job openings:
Remote Claims jobs near you
Adjudicator, Provider Claims

Adjudicator, Provider Claims

Molina Healthcare

Rochester, NY • Remote

$21.65 - $38.37/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 191 frontline employees who took The Breakroom Quiz

147th of 258 rated insurance

Job description

JOB DESCRIPTION Job Summary

Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims.

Essential Job Duties

Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution.  
Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. 
Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions.
Assists in reviews of state and federal complaints related to claims. 
Collaborates with other internal departments to determine appropriate resolution of claims issues. 
Researches claims tracers, adjustments, and resubmissions of claims.
Adjudicates or readjudicates high volumes of claims in a timely manner.
Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership.
Meets claims department quality and production standards.
Supports claims department initiatives to improve overall claims function efficiency.
Completes basic claims projects as assigned.
 

Required Qualifications

At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience.
Research and data analysis skills.
Organizational skills and attention to detail.
Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
Customer service experience.  
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.
 

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $21.65 - $38.37 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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