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Remote Health Claims Examiner Jobs in Raleigh, NC

Erie Insurance

Inside Claims Representative I

Raleigh, NC · On-site +1

$44K - $71K/yr

Remote Salary Range: $44,936.00 - $71,781.00 * salary range is for this level and may vary based on ... Premier health, prescription, dental, and vision benefits for you and your dependents. Coverage ...

New

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 24, 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 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 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.

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.

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, with some positions offering higher pay based on experience and certifications. The role often requires strong attention to detail, knowledge of insurance policies, and proficiency with claims processing software.

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 usually involves working independently in a home office environment with a standard work schedule.

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 2% As Needed, 76% Full Time, 16% Part Time, and 6% 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.

Inside Claims Representative I

Erie Insurance

Raleigh, NC • On-site, Remote

$44K - $71K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

New

Erie Insurance Group rating

8.8

Company rating: 8.8 out of 10

Based on 84 frontline employees who took The Breakroom Quiz

55th of 311 rated insurance

Job description

Division or Field Office:

Casualty Claims Division

Department of Position: Zones Dept 

Work from:

Remote Salary Range:

$44,936.00 - $71,781.00 *

salary range is for this level and may vary based on actual level of role hired for

*This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location (State) based on ERIE's geographical differences, and experience of an applicant, as well as level of role for which the successful candidate is hired. Position may be eligible for an annual bonus payment.

At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a diverse and inclusive team that includes more than 6,000 employees and over 13,000 independent agencies.  Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia. 
Benefits That Go Beyond The Basics

We strive to be Above all in Service to our customers-and to our employees. That's why Erie Insurance offers you an exceptional benefits package, including:

  • Premier health, prescription, dental, and vision benefits for you and your dependents. Coverage begins your first day of work.
  • Low contributions to medical and prescription premiums. We currently pay up to 97% of employees' monthly premium costs.
  • Pension. We are among the 2% of Fortune 500 companies to offer a traditional pension plan.  Full-time employees are vested after five years of services.
  • 401(k) with up to 4% contribution match. The 401(k) is offered in addition to the pension.
  • Paid time off. Paid vacation, personal days, sick days, bereavement days and parental leave.
  • Career development. Including a tuition reimbursement program for higher education and industry designations.
     

Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year.

Position Summary

Under close supervision, handles liability and property claims within designated authority. Resolves coverage and/or liability issues in accordance with applicable state insurance laws, regulations, and procedures.

 Candidates in proximity to Raleigh Branch office are preferred and will work from home.
Weekday evening shifts and/or Saturday shifts will be required based on business and service level needs.
The selected candidate will be required to obtain appropriate licensing within 45 days.
All Employees that work remotely must have access to internet service bandwidth speeds that meet ERIE's requirement of 50 mbps download and 10 mbps upload. 

Duties and Responsibilities
  • Investigates and adjudicates claims within designated authority, ensuring compliance with appropriate statutory laws. Verifies coverage, establishes and maintains reserves, secures recorded statements, drafts and processes correspondence, reports and records. Obtains additional information as required to determine liability.  Documents claim files and facilitates processing of claims in collaboration with other departments. Assigns outside experts when necessary to assist in investigation and in support of potential recovery.
  • Establishes contact with all parties involved in the claim in accordance with ERIE's expectations.
  • Evaluates and negotiates claims, recognizes subrogation opportunities, and initiates action. Sets up and/or issues payment using ERIE's approved payment methods for settlement; or declines payment within designated authority.
  • Responds to inquiries from Policyholders, Agents, insurance carriers, claimants, assigned experts and others.
  • Learns and maintains knowledge of liability laws for each state. Learns and maintains knowledge of motor vehicle codes. 
  • Learns and maintains knowledge of no fault/medical management/FPB laws for each state, including recognition of bodily injury claims.
  • With supervisor guidance, responds to intercompany arbitration applications. Files contentions and supporting documents on behalf of the insured/driver.
  • Conducts research, attends industry-related training programs and other training sessions to stay current on policy changes, interpretation, or new legislation.
  • Provides support for property claims during periods of heavy volume.


The first five duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished.
This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become clear.

Capabilities
  • Self-Development
  • Collaborates
  • Cultivates Innovation
  • Instills Trust
  • Decision Quality
  • Values Diversity
  • Nimble Learning
  • Customer Focus
  • Optimizes Work Processes (IC)
  • Ensures Accountability
  • Detail Orientation
  • Information Management Skills
  • Job-Specific Knowledge
Qualifications

Minimum Educational and Experience Requirements 

  • High school diploma or GED and two years of related claims handling or customer service experience, or equivalent educational experience required.  
  • Bachelor's or Associate's degree preferred.


Designations and/or Licenses 

  • Successful completion of Introduction to Insurance (INTRO) and Introduction to Claims (AIC 30) preferred.
  • Obtain appropriate licenses as required by state within 45 days of employment in the role for external applicants and 90 days of employment in the role for internal applicants. 
Physical Requirements
  • Manual Keying/Data Entry/inputting information/computer use; Frequent (50-80%)
  • Climbing/accessing heights; Rarely
  • Ability to move over 50 lbs using lifting aide equipment; Rarely
  • Driving; Never
  • Lifting/Moving 0-20 lbs; Rarely
  • Lifting/Moving 20-50 lbs; Rarely
  • Pushing/Pulling/moving objects, equipment with wheels; Rarely

What Erie Insurance Group employees say

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