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Remote Health Claims Examiner Jobs (NOW HIRING)

HealthEdge

Claims Examiner II

We're experiencing strong market momentum, with a growing number of health plans choosing ... Remote, US Type of Employment: Full-time, permanent Work Environment: The physical demands ...

HealthEdge

Claims Examiner II

We're experiencing strong market momentum, with a growing number of health plans choosing ... Remote, US Type of Employment: Full-time, permanent Work Environment: The physical demands ...

HealthEdge

Claims Examiner II

We're experiencing strong market momentum, with a growing number of health plans choosing ... Remote, US Type of Employment: Full-time, permanent Work Environment: The physical demands ...

Gallagher

Claims Examiner

Oakland, CA · Remote

Overview This is a remote position located in California. Keenan is a leading insurance brokerage ... The Claims Examiner is responsible for liability claims and property damage claims to their ...

Gallagher

Claims Examiner

Torrance, CA · Remote

Overview This is a remote position located in California. Keenan is a leading insurance brokerage ... The Claims Examiner is responsible for liability claims and property damage claims to their ...

NTT DATA Services

Claims Examiner Remote

Plano, TX · On-site +1

We are currently seeking a Claims Examiner Remote to join our team in Plano, Texas (US-TX), United ... in Healthcare Claims Processing 2+ year(s) using a computer with Windows applications using a ...

NTT DATA Services

Claims Examiner Remote

Plano, TX · On-site +1

We are currently seeking a Claims Examiner Remote to join our team in Plano, Texas (US-TX), United ... experience in Healthcare Claims Processing • 2+ year(s) using a computer with Windows ...

Globelife

Incontestable Claims Examiner I (Remote)

Globe Life is looking for an Incontestable Claims Examiner I to join the team! This role is ... Comprehensive health, dental, and vision insurance plans because your well-being is fundamental to ...

NTT DATA Services

Claims Examiner Remote

Plano, TX · On-site +1

We are currently seeking a Claims Examiner Remote to join our team in Plano, Texas (US-TX), United ... experience in Healthcare Claims Processing • 2+ year(s) using a computer with Windows ...

Berkley

AVP, Sr. Claims Examiner

Manhattan, NY · Remote

$132K - $189K/yr

... remote Key functions include but are not limited to: * Adjusting all aspects of claims and loss ... Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit ...

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Remote Health Claims Examiner information

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$15

$29

$45

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

As of Sep 8, 2026, the average hourly pay for remote health claims examiner in the United States is $29.40, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.10 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.
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Cities with the most Remote Health Claims Examiner job openings:

What states have the most Remote Health Claims Examiner jobs?

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Remote Health Claims Examiner jobs near you
Infographic showing various Remote Health Claims Examiner job openings in the United States as of September 2026, with employment types broken down into 2% As Needed, 77% Full Time, 16% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

Claims Examiner II

HealthEdge

Remote

Full-time

Posted 4 days ago

Job description

Overview
HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an increasingly competitive market. We're experiencing strong market momentum, with a growing number of health plans choosing HealthEdge to modernize their operations and compete more effectively. As we expand, we're investing in the people who power that growth, making this a pivotal moment to join us and shape the future of healthcare technology. Learn more at HealthEdge.com.
At UST HealthProof, you will join a fast paced, growing company in our mission to reshape the future of health insurance through significantly reducing administrative costs and building better healthcare experiences for our health plans customers and their members. By creating a modern, cloud based, Best-In-Class core administration ecosystem, we have made healthcare more affordable and helped our health plans operate more efficiently. Through member and provider touchpoints with less friction, we have created real impact for members.
UST HealthProof is run by leaders with strong health plan and technology backgrounds who have start-up mindsets and an environment of support where individual growth is nurtured. You will be supporting our proven core admin solutions and business process-as-a-service (BPaaS) operations to provide transparency, improve operational efficiency, and break down operational barriers to scale and drive strategic growth.
UST HealthProof is looking for Claims Examiner II, reporting to the Claims Team Leader. The Claims Examiner II is responsible for the adjudication of healthcare claims utilizing specific policies and procedures. This role is responsible for reviewing data within the claims processing system, to determine if services rendered were appropriate and benefit coverage criteria were met. The Claims Examiner II is accountable for reviewing the adjudication system edits to determine whether to pay the claim and/or line item(s).
As a Claims Examiner II at UST HealthProof, this is your opportunity to
  • Be responsible for processing assigned claims based on client-specified guidelines or as directed by the team leader
  • Be responsible for meeting productivity targets, financial and procedural accuracy standards as established by management
  • Mentor junior members of the team
  • Collaborate with other team members on special projects as assigned by the team leads; special projects can include process documentation development, training, quality audits, assisting with surge activity for the client(s), or any other project as determined by the team leader
  • Knowledge base around physician practices and hospital coding, billing and medical terminology, CPT, HCPCS, and ICD-10, UB04, CMS 1500, authorizations, medical terminology, and concepts of healthcare
  • Establish and maintain an appropriate level of communication with management to address issues and concerns and take preventive measures that ensure processing accuracy and quality
  • Participate in projects assigned by the team leader; these projects may include provider data, authorizations, enrollment, or other activities

You bring:
  • High School degree required
  • 1 - 3 years healthcare claims processing experience
  • Solid understanding and ability to analyse claim data
  • ICD-10 CPT and HCPCS coding, is a plus
  • Willingness to learn new skills
  • Team collaborator
  • Strong work ethic

For this role, we value:
  • The ability to adapt quickly to a fast-paced environment
  • A self-starter and quick learner
  • Team player with an ability to collaborate

Geographic Responsibility: Remote, US
Type of Employment: Full-time, permanent
Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:
  • The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
  • Work across multiple time zones in a hybrid or remote work environment.
  • Long periods of time sitting and/or standing in front of a computer using video technology.
  • May require travel dependent on company needs.

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check.
HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.
#LI-Remote
**The annual US hourly range for this position is $17.00 to $19.00/hr. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.
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About HealthEdge

Sourced by ZipRecruiter

Health Edge ® provides modern, disruptive technology that delivers for the first time, a suite of products that enables healthcare payors to leverage new business models, improve outcomes, drastically reduce administrative costs and connect everyone in the healthcare delivery cycle. Our next-generation enterprise product suite, HealthRules ®, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or on-site deployment. An award-winning company, HealthEdge empowers payors to capitalize on the innovations, challenges and opportunities that await in the new healthcare economy. For more information, visit .

Industry

Computer and computer peripheral equipment and software wholesalers

Company size

201 - 500 Employees

Headquarters location

Burlington, MA, US

Year founded

2005

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