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Remote Insurance Investigator Jobs in Tennessee (NOW HIRING)

MEM

Senior Claims Representative (Remote)

Columbia, TN · On-site +1

MEM Insurance is seeking a Senior Claims Representative to join our Claims team. In this pivotal role, you'll manage high-exposure workers' compensation claims, lead investigations into coverage and ...

Lineage Logistics Holding, LLC

This role focuses on investigating, diagnosing, and resolving operational software issues that ... This is a REMOTE role. Please note: We are unable to sponsor work authorization now or in the ...

HomeFirst Agency

Claims Adjuster

Maryville, TN · On-site +1

Hybrid - 3 days in office, 2 days remote after training. PAY: T h e expected hiring range for this ... Reviews insurance policies to determine coverageby working with Claims Trainers and ...

Oshi Health

Accounts Receivable Specialist

Nashville, TN · Remote

$19.50 - $25.75/hr

Manage assigned insurance accounts receivable to ensure timely reimbursement and reduce aging ... Investigate and resolve claim denials by submitting corrected claims, appeals, reconsiderations ...

IVX Health

Prior Authorization Coordinator

Brentwood, TN · On-site +1

$17.50 - $21.75/hr

Fully Remote, Hybrid, or In-office (Brentwood, TN) * Schedule : Monday - Friday, standard business ... requests to insurance providers. * Resolve Authorization Issues - Investigate and resolve ...

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Remote Insurance Investigator information

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$11

$23

$34

How much do remote insurance investigator jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for remote insurance investigator in Tennessee is $23.39, according to ZipRecruiter salary data. Most workers in this role earn between $19.86 and $28.80 per hour, depending on experience, location, and employer.

What does a remote insurance investigator do?

A typical day for a Remote Insurance Investigator involves reviewing and analyzing insurance claims for potential fraud, conducting interviews with claimants and witnesses over the phone or video calls, and gathering and verifying documentation. Investigators often prepare detailed reports, collaborate virtually with claims adjusters and legal teams, and may conduct online research or surveillance as part of an investigation. The role is primarily independent, requiring excellent time management, but also involves regular communication with supervisors and team members to discuss cases and share findings. This structure allows for flexible work hours, but also demands a high level of organization and self-discipline.

What is a remote insurance investigator?

A Remote Insurance Investigator examines insurance claims to detect fraud, verify information, and ensure compliance with policy terms, all while working from a remote location. They conduct interviews, analyze documents, review surveillance footage, and collaborate with insurance companies or law enforcement. Strong analytical skills, attention to detail, and experience in insurance or investigations are often required.

What are the key skills and qualifications needed to thrive as a remote insurance investigator?

To thrive as a Remote Insurance Investigator, you need a solid grasp of investigative techniques, analytical thinking, and a background in insurance claims, often supported by a degree in criminal justice or a related field. Familiarity with case management software, claims databases, and sometimes certifications such as CIFI (Certified Insurance Fraud Investigator) are commonly expected. Strong attention to detail, effective written and verbal communication skills, and self-motivation are crucial soft skills for this remote position. These skills enable investigators to efficiently detect fraud, manage complex caseloads, and communicate findings professionally from a remote work environment.

What are popular job titles related to Remote Insurance Investigator jobs in Tennessee? For Remote Insurance Investigator jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Investigator jobs in Tennessee look for? The top searched job categories for Remote Insurance Investigator jobs in Tennessee are:
What cities in Tennessee are hiring for Remote Insurance Investigator jobs? Cities in Tennessee with the most Remote Insurance Investigator job openings:
Remote Insurance Investigator jobs near you
Infographic showing various Remote Insurance Investigator job openings in Tennessee as of August 2026, with employment types broken down into 70% Full Time, and 30% Part Time. Highlights an 100% Remote job distribution, with an average salary of $48,650 per year, or $23.4 per hour.

Senior Claims Representative (Remote)

MEM

Columbia, TN • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Job description

Are you a seasoned claims professional with a passion for navigating complex cases? MEM Insurance is seeking a Senior Claims Representative to join our Claims team. In this pivotal role, you’ll manage high-exposure workers’ compensation claims, lead investigations into coverage and fraud, and collaborate across departments to drive strategic outcomes. You’ll be a key decision-maker, a mentor to junior adjusters, and a champion of process improvement—all while ensuring exceptional service and regulatory compliance.   At MEM Insurance, we don’t just protect our customers—we empower our employees. We foster a culture of integrity, collaboration, and innovation. Our team thrives on solving challenges together, supporting one another, and making a meaningful impact in the lives of our policyholders and injured workers.     Essential Duties and Responsibilities: Claims Handling & Administration
  • Manage highly complex claims involving significant financial exposure, legal intricacies, and extended life cycles.
  • Conduct advanced investigations into coverage and compensability, including nuanced statutory interpretations.
  • Oversee medical case management for catastrophic injuries and lifetime care needs.
  • Review and authorize large or complex medical bills, negotiating adjustments to control costs.
Return-to-Work Management
  • Develop comprehensive RTW strategies in collaboration with policyholders, legal counsel, and vocational consultants.
  • Ensure precision in benefit calculations for high-exposure claims, addressing tax and compliance risks.
  • Strategically deploy investigative efforts aligned with broader claims strategy.
Claims Investigation & Loss Prevention
  • Lead investigations into complex fraud cases and collaborate with the Special Investigations Unit.
  • Conduct subrogation analysis and negotiate with third-party insurers or attorneys for maximum recovery.
Settlements & Negotiation
  • Partner with legal teams to negotiate complex settlements and manage litigation processes.
  • Oversee Medicare compliance initiatives, including Medicare Set-Asides and CMS engagement.
  • Identify opportunities for structured settlements and lead negotiations.
Reporting
  • Produce strategic reports on high-profile claims to guide management decisions.
  • Maintain system data integrity and prepare claims for Corporate Plan of Action meetings.
Collaboration
  • Lead cross-departmental efforts to improve claims handling and risk management.
  • Resolve escalated customer service issues and support high-value accounts.
  • Participate in workflow improvement initiatives and committees.
Team Leadership
  • Mentor and coach junior and intermediate adjusters.
  • Review escalated claims and provide actionable feedback.
  • Support workforce development and succession planning.
  Qualifications:
  • Bachelor’s degree in business or related field preferred, or equivalent industry experience.
  • 7–10 years of claims handling experience, with high exposure to Workers’ Compensation.
  • Associate in Claims (AIC), AIM, or CPCU designation preferred or ability to obtain.
  • Texas All-Lines license preferred.
  • Valid driver’s license required.
  Company Culture and Values At MEM Insurance, we are committed to our vision, mission, and values. We foster a culture of collaboration, integrity, and innovation. Our team is passionate about delivering exceptional service to our customers while supporting each other’s growth and success. We believe in accountability, continuous learning, and creating an environment where employees feel valued and empowered.     Connection and Belonging MEM Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that varied perspectives drive innovation and strengthen our ability to serve our customers and communities.     Total Rewards Overview
  • Health Plans: Medical, Dental, and Vision
    Includes fertility benefits, fully paid preventative care, and adult orthodontia.
  • Employer-Paid Life and Disability Benefits:
    Life Insurance (3x base salary), AD&D, Short and Long-term Disability.
  • Wellness and Recognition Program: Employer-paid incentives for employees and spouses.
  • Flexible Spending Account and Dependent Care options
  • Health Savings Account: Generous employer contribution.
  • Time Away from Work:
    Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave.
  • Employee Assistance Programs
  • 401k Retirement Plan: Employer match and profit sharing.
  • Adoption Assistance and Tuition Assistance
  Notice Regarding Use of Artificial Intelligence
MEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws.
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About Mem

Sourced by ZipRecruiter

Industry

Internet and it

Company size

1 - 10 Employees

Headquarters location

Los Altos Hills, CA, US

Year founded

2019

Social media

Twitter

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