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Remote Health Claims Examiner Jobs in Raleigh, NC

Deloitte

Epic Denials Management Operator

Raleigh, NC · 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 ...

Senture

Medical Director

Raleigh, NC · Remote

While this position allows remote work, the individual must reside within the state of North ... claims resolution, or medical review functions within commercial and/or government-sponsored health ...

Magicforce

Facets Analyst

Raleigh, NC · Remote

$60 - $65/hr

Job Title: Facets Analyst Location: 100% Remote Duration: 12+ Months Mandatory Skills: Facets with claims knowledge is must Facets , US healthcare payer domain, claims processing, analytical skills ...

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 ... Resolves disputed claims by gathering, verifying, and providing additional information * Identify ...

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Remote Health Claims Examiner information

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How much do remote health claims examiner jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for remote health claims examiner in Raleigh, NC is $28.58, according to ZipRecruiter salary data. Most workers in this role earn between $21.73 and $34.13 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a remote health claims examiner?

To thrive as a Remote Health Claims Examiner, you need strong analytical skills, attention to detail, and a solid understanding of healthcare billing and insurance claims processes, often supported by a relevant associate degree or experience in medical coding. Familiarity with claims management software, ICD-10 and CPT coding, and possibly certification like Certified Professional Coder (CPC) is typically required. Excellent written communication, time management, and problem-solving abilities are crucial soft skills for success in a remote environment. These competencies ensure accurate claims processing, compliance with regulations, and efficient resolution of claims, which are vital for organizational effectiveness and customer satisfaction.

How to become a remote health claims examiner?

To become a remote health claims examiner, candidates typically need a high school diploma or equivalent, with some roles requiring an associate's or bachelor's degree in health administration, insurance, or related fields. Relevant skills include attention to detail, knowledge of medical terminology, and proficiency with claims processing software; certifications such as the Certified Professional Coder (CPC) can enhance prospects. Employers often provide training, and the role involves working remotely with a standard schedule, adhering to privacy and compliance standards.

How much do remote health claims examiners make in the US?

Remote health claims examiners in the US typically earn between $40,000 and $60,000 annually, depending on experience, certifications, and employer. The role often requires attention to detail, knowledge of insurance policies, and proficiency with claims processing software.

What does a remote health claims examiner do?

A Remote Health Claims Examiner reviews and processes insurance claims for healthcare services from a remote location, typically working from home. They analyze medical records, verify patient information, ensure that claims comply with policy requirements, and determine the appropriate amount to be paid. Their job also involves identifying fraudulent claims, communicating with healthcare providers, and ensuring accurate and timely claim resolution. Strong attention to detail, knowledge of medical terminology, and familiarity with insurance regulations are essential skills for this role.

What are some common challenges faced by remote health claims examiners, and how can they be effectively managed?

Remote Health Claims Examiners often encounter challenges such as interpreting complex medical documentation, staying updated on ever-changing insurance policies, and maintaining productivity while working independently. Effective time management, strong organizational skills, and clear communication with team members and providers are key to overcoming these hurdles. Utilizing training resources and actively participating in virtual meetings can also help remote examiners stay connected and informed about industry updates.

What are popular job titles related to Remote Health Claims Examiner jobs in Raleigh, NC?

For Remote Health Claims Examiner jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Remote Health Claims Examiner jobs in Raleigh, NC look for?

The top searched job categories for Remote Health Claims Examiner jobs in Raleigh, NC are:

Remote Health Claims Examiner jobs near you
Infographic showing various Remote Health Claims Examiner job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 18% Part Time, and 5% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $59,449 per year, or $28.6 per hour.

Epic PB/PB Claims Analyst

The Select Group

Morrisville, NC • On-site, Remote

Full-time

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

Job description

EPIC PB/CLAIMS ANALYST | REMOTE (EST)
The Select Group is seeking an Epic PB/PB Claims Analyst to support a large Community Connect initiative with one of our top healthcare partners. This individual will play a key role in supporting Professional Billing (PB) and PB Claims workflows, revenue cycle optimization initiatives, and implementation efforts related to onboarding affiliated entities into the Epic environment. They will assist with workflow analysis, build support, testing, troubleshooting, and operational readiness efforts throughout the Community Connect project lifecycle.
WHAT YOU'LL CONTRIBUTE
  • Support the successful implementation and optimization of Epic Professional Billing (PB) and PB Claims workflows across affiliated organizations
  • Partner with revenue cycle, operational, and Epic application teams to align workflows and drive project objectives
  • Contribute to Community Connect onboarding efforts by analyzing current-state processes and supporting future-state workflow design
  • Help improve claims accuracy, reimbursement efficiency, and overall revenue cycle performance through workflow support and issue resolution
  • Participate in testing, validation, and go-live activities to support operational readiness and a smooth transition into the Epic environment
  • Provide documentation, troubleshooting support, and recommendations for ongoing system and workflow optimization throughout the project lifecycle

EPIC PB/CLAIMS ANALYST RESPONSIBILITIES
  • Support Epic PB and PB Claims implementation and optimization activities
  • Assist with Community Connect onboarding and revenue cycle workflow alignment
  • Collaborate with revenue cycle, operational, and Epic application teams
  • Support claims processing workflows, charge review activities, claim edits, and reimbursement processes
  • Participate in workflow analysis, testing, validation, and issue resolution activities
  • Assist with build review, configuration updates, and system optimization efforts
  • Support end-user operational readiness and go-live activities
  • Document workflows, decisions, and implementation updates
  • Participate in project meetings with operational and technical stakeholders

EPIC PB/CLAIMS REQUIREMENTS
  • Active Epic PB certification required
  • Strong experience supporting Epic PB and PB Claims workflows required
  • Experience supporting healthcare revenue cycle workflows in complex healthcare environments
  • Previous Community Connect or Epic implementation experience
  • Experience with claims management, reimbursement workflows, and charge review processes
  • Strong understanding of Professional Billing operations
  • Strong troubleshooting, communication, and documentation skills
  • Ability to work cross-functionally with operational and technical teams

Bonus Qualifications
  • Additional Epic revenue cycle certifications preferred
  • Experience supporting large health systems or academic medical centers
  • Revenue cycle optimization experience
  • Go-live or operational readiness support experience
  • Experience with workflow redesign or process improvement initiatives

TSG is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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