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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% ...

Randstad

Claims WFH - Health Insurance

Houston, TX · Remote

$21 - $23/hr

HIRING NOW - WFH CLAIMS SPECIALIST We are seeking a detail-oriented and experienced Claims ... Location: 100% Remote (Available to candidates residing in 28 approved states) * Compensation: $21 ...

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 ...

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Remote Insurance Claims Specialist information

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

As of Jul 19, 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 91% Full Time, 7% Part Time, and 2% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $48,885 per year, or $23.5 per hour.

Claims Specialist with FineOS - Remote

Northern Base

Cincinnati, OH • Remote

Full-time

PTO

Posted 12 days ago

Job description

Claims Specialist with FineOS
Remote
Fulltime

Responsibilities:
To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments.
Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or continuous)
Review and analyze medical information (i.e. attending physician reports, medical records such as diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined.
Approval or denial on FMLA claims as per Insurance carrier, and employer’s guidelines
Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to US paid family law regulations.
Review claims for Not in good order cases, and work on securing missing documentations including employee, physician, or employer outreach.
Communicates clearly with the claimants and clients to set expectations on all aspects of claims process either by phone and/or written correspondence.
Reviews client critical deliverables, manages the overall workload, and second-level process escalation.
Determines benefits due, makes timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets.
Refers cases as appropriate to team lead and clinical case management
Responsible for managing the day-to-day workload and first-level process escalation, and reviews processes for accuracy and timeliness where applicable in case of peer reviews.
Provide ideas to management on continuous improvement and service level management
Performs other duties or participates in special projects as assigned

Requirements:
1+ year of Disability/FMLA/PFL claims or insurance claims experience
Experience working with FINEOS
Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports
Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices mandatory
Excellent oral and written communication, including presentation skills
Strong Analytical, decision making, problem solving, and people management skills
Computer experience with keyboarding skills and proficiency in using software applications and packages including MS Office (Excel, Word, PPT)
Willingness to embrace change in a fast paced work environment
A strong desire to continuously learn and improve
Identify escalated cases and work with Team Leader to develop a plan to address key issues.