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Remote Healthcare Claims Adjudication Jobs (NOW HIRING)

System One

Healthcare Claims Adjuster

Baltimore, MD · Remote

$25/hr

Contract To Hire Compensation : $25/HR Contractor Work Model : 80% Remote (must reside in D.C., MD, or VA per client) About the Role We're hiring a Healthcare Claims Adjuster with a strong claims ...

System One

Healthcare Claims Adjuster

Baltimore, MD · Remote

$25/hr

Contract To Hire Compensation : $25/HR Contractor Work Model : 80% Remote (must reside in D.C., MD, or VA per client) About the Role We're hiring a Healthcare Claims Adjuster with a strong claims ...

System One

Healthcare Claims Adjuster

Baltimore, MD · Remote

$25/hr

Contract To Hire Compensation : $25/HR Contractor Work Model : 80% Remote (must reside in D.C., MD, or VA per client) About the Role We're hiring a Healthcare Claims Adjuster with a strong claims ...

Educology Solutions

QNXT Accumulators SME

Washington, DC · Remote

Deep understanding of healthcare claims processing and the direct impact of accumulators on adjudication logic. Strong practical experience with enrollment data structures, tables, and the downstream ...

New

Molina Healthcare

Examiner, Claims

Long Beach, CA · Remote

$14 - $26.42/hr

Essential Job Duties Evaluates the adjudication of claims using standard principles, and state ... Preferred Qualifications Health care claims/billing experience. #PJClaims2 #LI-AC1 To all current ...

CVS Health

Claims Negotiation Manager

$66K - $145K/yr

Demonstrated expertise in the No Surprises Act (NSA), out-of-network reimbursement methodologies, provider billing practices, and healthcare claims adjudication, with the ability to interpret complex ...

HJ Staffing

QNXT Program Manager

Long Beach, CA · On-site +1

Long Beach, CA (100% Remote) Schedule: Monday - Friday, 8:00 AM - 5:00 PM (PST) Start Date: 08/10 ... healthcare payer claims operations and the end-to-end claims lifecycle (adjudication, pricing ...

HJ Staffing

QNXT Program Manager

Long Beach, CA · On-site +1

Long Beach, CA (100% Remote) Schedule: Monday - Friday, 8:00 AM - 5:00 PM (PST) Start Date: 08/10 ... healthcare payer claims operations and the end-to-end claims lifecycle (adjudication, pricing ...

WinChoice USA

QNXT Program Manager

Long Beach, CA · Remote

Long Beach, CA (100% Remote) Schedule: Monday - Friday, 8:00 AM - 5:00 PM (PST) Start Date: 08/10 ... healthcare payer claims operations and the end-to-end claims lifecycle (adjudication, pricing ...

New

Machinify

Senior Data Analyst

$88K - $111K/yr

Mentor analysts and engineers on healthcare domain questions - serving as the go-to SME on coding, claims adjudication, and payer policy * Document transformation logic, data lineage, and analytical ...

Sourcedge Solutions

FACETS Claims Processor

Albany, NY · Remote

$17 - $21.25/hr

Remote Reply at: Jobs@sourcedge.com FACETS SENIOR CLAIMS PROCESSOR * 5 Years Facets Claims ... Must have 5+ years of relevant claim processing experience in healthcare industry (managed care or ...

Machinify

Senior Data Analyst

$140K - $170K/yr

Mentor analysts and engineers on healthcare domain questions - serving as the go-to SME on coding, claims adjudication, and payer policy * Document transformation logic, data lineage, and analytical ...

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Remote Healthcare Claims Adjudication information

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How much do remote healthcare claims adjudication jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for remote healthcare claims adjudication 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 is a remote healthcare claims adjudicator?

A Remote Healthcare Claims Adjudicator is a professional who reviews and processes medical insurance claims from a remote location, usually working from home. They are responsible for evaluating submitted claims to determine if they comply with insurance policies and guidelines, ensuring that healthcare providers and patients receive accurate payments or denials. This involves verifying patient eligibility, reviewing medical documentation, and applying appropriate codes and regulations. Remote adjudicators must be detail-oriented, knowledgeable about medical terminology and insurance processes, and comfortable using digital systems to manage claims.

What are the key skills and qualifications needed to thrive as a remote healthcare claims adjudicator?

To thrive as a Remote Healthcare Claims Adjudicator, you need a solid understanding of medical billing, insurance policies, and claims processing, often supported by experience in healthcare administration or a relevant certification. Familiarity with claims management software, ICD/CPT coding systems, and electronic data interchange (EDI) platforms is typically required. Strong attention to detail, analytical thinking, and effective communication skills help you navigate complex cases and resolve discrepancies efficiently. These competencies are critical for ensuring accurate claims adjudication, minimizing errors, and supporting timely reimbursement in a remote work environment.

What are some common challenges faced when working remotely as a healthcare claims adjudicator, and how can they be managed?

One common challenge in remote healthcare claims adjudication is maintaining effective communication with team members and supervisors, especially when clarifying complex claims or policy guidelines. Additionally, adjudicators may find it difficult to stay updated on frequently changing regulations and payer requirements without in-person support. To overcome these challenges, it's helpful to proactively participate in virtual team meetings, utilize collaborative platforms, and regularly review updates from management. Prioritizing organizational skills and maintaining a dedicated, distraction-free workspace also supports productivity and accuracy in claim processing.
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Remote Healthcare Claims Adjudication jobs near you
Infographic showing various Remote Healthcare Claims Adjudication job openings in the United States as of August 2026, with employment types broken down into 1% Locum Tenens, 2% As Needed, 66% Full Time, 16% Part Time, and 15% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

Healthcare Claims Adjuster

System One

Baltimore, MD • Remote

$25/hr

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 19 days ago

Job description

Job Title: Healthcare Claims Adjuster

Location: Baltimore, Maryland (meetings and tranings) Type: Contract To Hire Compensation: $25/HR Contractor Work Model: 80% Remote (must reside in D.C., MD, or VA per client)

About the Role We’re hiring a Healthcare Claims Adjuster with a strong claims processing background and exposure to adjustments, rework, or dispute resolution who wants to grow in that area. The role involves handling claims adjustments, discrepancies, and provider dispute work.

This is a fast-paced role with the opportunity to build hands-on adjustment experience and potential for long-term growth. What You’ll Do Processing (Training Ramp-Up)

  • Process medical claims and learn systems and workflows
Adjustments & Disputes (Core Role)
  • Investigate and resolve claim discrepancies and provider disputes
  • Perform adjustments, reprocessing, and corrections
  • Review overpayments, underpayments, and errors
Daily Operations
  • Handle high volume (~50 cases/day after ramp-up)
  • Update claims systems and maintain accurate records
  • Shift between processing and adjustment work
Quality & Accuracy
  • Identify trends and exceptions
  • Ensure accuracy and compliance
Why This Role Is a Great Fit
  • Grow adjustment expertise (not just processing)
  • Exposure to complex claims and dispute resolution
  • High-impact work on claim backlog
  • Mostly remote, flexible work model
  • Contract-to-hire with potential for full-time conversion based on performance
What You Bring Required Skills:
  • 2+ years of medical claims experience
  • Strong claims processing background
  • Adjustment experience (rework, discrepancies, or dispute resolution)
  • Ability to work in a fast-paced, high-volume environment
  • Strong attention to detail and problem-solving skills
Nice to Have (sets you apart):
  • Payer-side experience
  • FACETS or similar claims system experience
  • Exposure to refunds, subrogation, or workers’ compensation

System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

#M-1 #LI-AJ1 Ref: #851-Rockville-S1

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About System One

Sourced by ZipRecruiter

System One helps employers get work done more efficiently and economically without compromising quality. Over our 35+ year history, we've helped connect thousands of talented people with innovative companies. The excitement of a perfect fit motivates us every single day.

Industry

Business consulting services and recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Pittsburgh, PA, US

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