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Remote Insurance Claims Specialist Jobs (NOW HIRING)

Allied Tech

Claims Specialist

Austin, TX · Remote

$48K - $60K/yr

Claims Specialist We support clients by keeping their insurance claims processing organized ... Fully remote position * Competitive health, dental, and vision insurance * 401(k) with up to 6% ...

BrightSpring

340B Claims Specialist

Blanco, TX · Remote

Remote Flexibility : This position is 100% remote, giving you the freedom to work from anywhere! ... Company-Paid Disability Insurance * Tuition Assistance & Reimbursement * Employee Discount Program ...

PharMerica

340B Claims Specialist

Blanco, TX · Remote

Remote Flexibility : This position is 100% remote, giving you the freedom to work from anywhere! ... Company-Paid Disability Insurance * Tuition Assistance & Reimbursement * Employee Discount Program ...

Spotter

This remote position is vital in ensuring that our clients receive prompt and fair assessments of ... Experience in claims processing, insurance, or a related field is preferred. Understanding of ...

WVU Medicine

Insurance Claims Specialist PB

Other duties may be assigned. 1. Submits accurate and timely claims to third party payers. 2. Resolves claim edits and account errors prior to claim submission. 3. Adheres to appropriate procedures ...

Next Insurance

Claims Specialist

Charleston, WV · Remote

Remote ERGO NEXT's mission is to help entrepreneurs thrive. We're doing that by building the only ... We're backed by industry leaders in insurance and tech, and we still have room to grow -- that ...

WVU Medicine

Insurance Claims Specialist HB

Other duties may be assigned. 1. Submits accurate and timely claims to third party payers. 2. Resolves claim edits and account errors prior to claim submission. 3. Adheres to appropriate procedures ...

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Remote Insurance Claims Specialist information

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$43

How much do remote insurance claims specialist jobs pay per hour?

As of Aug 2, 2026, the average hourly pay for remote insurance claims specialist in the United States is $23.50, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $25.72 per hour, depending on experience, location, and employer.

What is the difference between Remote Insurance Claims Specialist vs Remote Insurance Adjuster?

AspectRemote Insurance Claims SpecialistRemote Insurance Adjuster
Required CredentialsTypically requires insurance claims processing certification or relevant experienceOften requires state licensing and adjuster certification
Work EnvironmentPrimarily administrative, customer service, and claims processingField and desk work, assessing damages and inspecting claims
Employer & Industry UsageInsurance companies, third-party administrators, and claims centersInsurance carriers, independent adjusting firms, and claims agencies
Search & Comparison IntentPeople looking for remote claims processing rolesPeople comparing claims handling and damage assessment roles

The main difference is that Remote Insurance Claims Specialists focus on processing and managing claims remotely, often requiring claims certification, while Remote Insurance Adjusters assess damages and inspect claims, often needing licensing. Both roles are essential in the insurance industry but differ in responsibilities and certification requirements.

What are some common challenges faced by Remote Insurance Claims Specialists, and how can they be managed effectively?

Remote Insurance Claims Specialists often encounter challenges such as staying organized while managing multiple claims, maintaining clear communication with clients and team members, and ensuring compliance with regulations from a home office setting. To manage these effectively, specialists can utilize robust digital claim management systems, establish regular check-ins with supervisors and colleagues, and set up a dedicated, distraction-free workspace. Being proactive with time management and leveraging collaboration tools are key to maintaining productivity and delivering high-quality customer service in a remote environment.

What are the key skills and qualifications needed to thrive as a Remote Insurance Claims Specialist, and why are they important?

To thrive as a Remote Insurance Claims Specialist, you need a solid understanding of insurance policies, claims processing, and attention to detail, often supported by relevant experience or an associate degree. Familiarity with claims management software, customer relationship management (CRM) systems, and sometimes certification such as AIC (Associate in Claims) is typically required. Strong communication, problem-solving, and self-motivation are crucial soft skills for effectively handling client inquiries and resolving claims remotely. These skills ensure efficient claim resolution, customer satisfaction, and compliance with industry regulations in a remote work environment.

What does a Remote Insurance Claims Specialist do?

A Remote Insurance Claims Specialist is responsible for evaluating and processing insurance claims from customers, typically working from home or another remote location. Their main duties include reviewing claim forms, verifying information, investigating cases, and determining the validity and value of claims. They communicate with policyholders, medical providers, and other parties to gather necessary documentation and ensure claims are handled efficiently and accurately. Specialists must be detail-oriented, knowledgeable about insurance policies, and skilled in customer service. Working remotely, they rely heavily on technology to manage claims workflows and maintain confidentiality.
More about Remote Insurance Claims Specialist jobs
What cities are hiring for Remote Insurance Claims Specialist jobs? Cities with the most Remote Insurance Claims Specialist job openings:
What states have the most Remote Insurance Claims Specialist jobs? States with the most job openings for Remote Insurance Claims Specialist jobs include:
What job categories do people searching Remote Insurance Claims Specialist jobs look for? The top searched job categories for Remote Insurance Claims Specialist jobs are:
Remote Insurance Claims Specialist jobs near you
Infographic showing various Remote Insurance Claims Specialist job openings in the United States as of July 2026, with employment types broken down into 90% Full Time, 8% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

Claims Specialist II (Medical Claims / Coordination of Benefits)

Strategic Staffing Solutions

Baton Rouge, LA • Remote

$19/hr

Other

Medical

Posted yesterday

New

Job description

Job Description Claims Specialist II (Medical Claims / Coordination of Benefits) Location: Remote (Louisiana Preferred) Contract Length: 5 Months Pay Rate: Up to $19/hour (W2) Industry: Health Insurance / Medical Claims Position Summary We are seeking an experienced Claims Specialist II with medical claims processing experience to support a high-volume health insurance claims operation. This position is responsible for processing and adjusting medical claims, researching claim issues, determining Coordination of Benefits (COB), recovering overpayments, and ensuring claims are processed accurately while maintaining compliance with HIPAA and company policies. Louisiana candidates are preferred.

This is a remote opportunity. Required Qualifications High School Diploma or equivalent Minimum 2 years of medical claims processing experience Claims processing experience is required Coordination of Benefits (COB) experience strongly preferred Experience determining primary vs. secondary insurance coverage Knowledge of medical claims adjudication and claims edits Strong analytical, problem-solving, and investigative skills Excellent verbal and written communication skills Working knowledge of Microsoft Office and claims processing systems Ability to prioritize multiple workstreams in a fast-paced environment Preferred Experience Hands-on Coordination of Benefits (COB) processing Medicare coordination and primacy determination Provider reimbursement and overpayment recovery Health insurance or managed care environment Key Responsibilities Process medical claims, claims edits, and claims adjustments accurately.

Research and determine the correct Coordination of Benefits (COB) for members with multiple insurance plans. Identify primary and secondary coverage using subscriber status, plan type, Medicare coordination, and effective dates. Review and update claims to ensure proper payment and reimbursement.

Investigate and resolve complex claims issues and discrepancies. Process refunds and recover overpayments from providers or members. Communicate with providers, members, Medicare, and other insurance carriers regarding claim status and coverage.

Maintain accurate claims records while ensuring compliance with HIPAA and regulatory requirements. Review quality audits and complete corrections within departmental guidelines. Support special projects, training initiatives, and departmental process improvements.

Preferred Knowledge Medical claims adjudication Coordination of Benefits (COB) Medicare primacy rules Provider reimbursement Claims adjustments and overpayment recovery HIPAA compliance Medical terminology Health insurance operations Ideal Background Candidates with experience in organizations such as: Blue Cross Blue Shield UnitedHealthcare / Optum Humana Elevance Health (Anthem) Aetna / CVS Health Cigna Centene Molina Healthcare Kaiser Permanente Highmark GuideWell / Florida Blue CareFirst HealthPartners AmeriHealth This opportunity is ideal for candidates with strong medical claims processing and Coordination of Benefits (COB) experience who thrive in a detail-oriented, production-focused healthcare environment.

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