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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 26, 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 1% As Needed, 80% Full Time, 13% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $59,449 per year, or $28.6 per hour.

Sr Epic Resolute (Billing & Claims) Certified Analyst

Morrisville, NC • On-site, Remote

UNC HEALTH
Health Care and Social Assistance • 10K+ employees

7.0

Company rating: 7.0 out of 10

Based on 321 frontline employees who took The Breakroom Quiz

414th of 893 rated healthcare providers

People enjoy working here

Recommended by students

Recommended by parents

Learn more about UNC HEALTHexternal

$41.45 - $59.58/hr

Full-time

Re-posted 3 days ago

Job description

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.
Summary:
UNC Health is seeking an experienced Epic Resolute Certified Analyst to support our Community Connect program. This role supports external partner clinics using UNC Health's Epic platform, with a focus on professional billing (PB), claims management, and end-to-end revenue cycle workflows, with strong alignment to ambulatory operations.
Location: Morrisville, NC (Hybrid: Remote & Onsite)
Team: Community Connect | UNC Health ISD
Responsibilities:
  • Design, build, and support Epic Resolute (Professional Billing & Claims) functionality
  • Maintain billing rules, including charge routing, claim edits, payer setup, and workqueues
  • Support charge capture, claim submission, payment posting, denials, and A/R workflows
  • Troubleshoot billing and claims issues, including rejections, denials, and workflow gaps
  • Partner with revenue cycle, coding, and operational teams to optimize workflows and reduce revenue leakage
  • Support requirements gathering, testing, go-lives, and system enhancements
  • Provide onsite clinic support, including workflow analysis and optimization
  • Ensure data integrity, compliance, and reporting support for revenue cycle performance

Preferred Qualifications:
  • Epic Resolute Certification (Professional Billing) (active)
  • 3+ years of Epic Resolute experience in a healthcare environment
  • Strong knowledge of billing, claims processing, and revenue cycle operations
  • Experience with claim edits, denials management, and A/R follow-up workflows
  • Ability to travel to clinics for onsite support
  • Experience with Community Connect or multi-site environments
  • Experience with workqueues, claim scrubbing, and payer/plan build
  • Understanding of ambulatory (PB) workflows and integrations with Cadence/Prelude
  • Experience supporting go-lives, testing (UAT), and workflow optimization initiatives

Other Information
Education Requirements:
• Bachelor's degree in Computer Science, Information Systems Management or related field (or equivalent combination of education, training and experience).
Licensure/Certification Requirements:
• No licensure or certification required.
Professional Experience Requirements:
• If a Bachelor's degree: Four (4) years of experience with IT systems and/or related operational experience.
• If an Associate's degree: Six (6) years of IT systems and/or related operational experience.
• If a High School diploma or GED: Eight (8) years of IT systems and/or related operational experience.
Knowledge/Skills/and Abilities Requirements:
  • Epic Resolute Certification (Professional Billing) (active)
  • 3+ years of Epic Resolute experience in a healthcare environment
  • Strong knowledge of billing, claims processing, and revenue cycle operations
  • Experience with claim edits, denials management, and A/R follow-up workflows
  • Ability to travel to clinics for onsite support
  • Excellent analytical and communication skills. Ability to work well in a team environment. Demonstrated ability to successfully manage multiple tasks simultaneously. Highly responsive to internal customers.

Job Details
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: ISD Ambulatory Services
Work Type: Full Time
Standard Hours Per Week: 40.00
Salary Range: $41.45 - $59.58 per hour (Hiring Range)
Pay offers are determined by experience and internal equity
Work Assignment Type: Hybrid
Work Schedule: Day Job
Location of Job: US:NC:Morrisville
Exempt From Overtime: Exempt: Yes
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.

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