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Remote Medical Claims Examiner Jobs (NOW HIRING)

Insperity

Medical Claims Examiner

Los Angeles, CA · On-site +1

$20 - $25/hr

General information Client / Corporate Client Work Mode Hybrid Name Medical Claims Examiner Job ID 21986 City Chatsworth (Local Remote) Published date 07-Jul-2026 State California Country United ...

Insperity

Medical Claims Examiner

CA · On-site +1

$20 - $25/hr

Description & Requirements Medical Claims Examiner Local Remote or In-Office Join a team where your attention to detail and commitment to quality care make a difference. Thrifty Management Services ...

Imagenet

Claims Examiner - Remote

Tampa, FL · Remote

Claims Examiner - Remote Job Type: Full-time Work Setup: This is a fully remote position Work Hours ... Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of ...

ImageNetLLC

Claims Examiner - Remote

Tampa, FL · Remote

Salary: Claims Examiner - Remote Job Type: Full-time Work Setup: This is a fully remote position ... Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of ...

ImagenetLLC

Claims Examiner - Remote

Tampa, FL · Remote

Claims Examiner - Remote Job Type : Full-time Work Setup: This is a fully remote position Work ... Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of ...

Trident

Medical Claims Examiner

$30/hr

We are seeking a highly skilled and independent Claims Examiner to join our team on a 100% remote ... Because this is a fully remote, independent contractor position, we are looking for a self-starter ...

Imagenet

Claims Examiner - Remote

Tampa, FL · On-site +1

Claims Examiner - Remote Job Type: Full-time Work Setup: This is a fully remote position Work Hours ... Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of ...

Western Growers

Claims Examiner I

Fresno, CA · On-site +1

$40K - $52K/yr

Claims Examiner I is responsible for reviewing and processing medical, dental, vision, and electronic claims per state, federal, and health plan regulatory requirements and department guidelines, as ...

Allcat Claims Service

Flood Claims Examiner Location: Remote Department: Flood - Quality Assurance Primary Duties ... Medical, Dental, Vision, Paid Time Off and Paid Holidays, 401(K), in accordance with Company policy.

Allcat Claims Service

Flood Claims Examiner Location: Remote Department: Flood - Quality Assurance Primary Duties ... Medical, Dental, Vision, Paid Time Off and Paid Holidays, 401(K), in accordance with Company policy.

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Remote Medical Claims Examiner information

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

As of Jul 28, 2026, the average hourly pay for remote medical 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.

How does working remotely as a Medical Claims Examiner impact collaboration with healthcare providers and internal teams?

Working remotely as a Medical Claims Examiner often relies heavily on digital communication tools to collaborate with healthcare providers, billing departments, and internal claims teams. While you may not have face-to-face contact, regular virtual meetings, emails, and secure messaging platforms are used to clarify claim details, resolve discrepancies, and ensure timely processing. Successful remote examiners are proactive communicators and often participate in team huddles or check-ins to stay aligned on policies and workflow updates. Building strong virtual relationships is key to overcoming the challenge of not being onsite, and most organizations provide training and support for effective remote collaboration.

What is the difference between Remote Medical Claims Examiner vs Remote Medical Claims Processor?

AspectRemote Medical Claims ExaminerRemote Medical Claims Processor
Required CredentialsMedical background, certifications like CPC or CCSBasic insurance knowledge, often no medical credentials needed
Work EnvironmentHome-based, insurance companies, healthcare providersHome-based, insurance companies, healthcare providers
Job FocusReviewing medical claims for accuracy and coverageProcessing claims, data entry, and initial review
Common UsageUsed in insurance and healthcare industriesUsed in insurance companies and claims departments

The main difference is that Remote Medical Claims Examiners review and evaluate medical claims for accuracy and coverage, often requiring medical credentials. In contrast, Remote Medical Claims Processors handle the initial processing and data entry of claims, typically without medical certifications. Both roles are remote and serve the insurance industry, but the Claims Examiner role involves more specialized medical review.

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

To thrive as a Remote Medical Claims Examiner, you need a strong understanding of medical terminology, healthcare regulations, and claims processing, often supported by a degree in health administration or a related field. Familiarity with claims management systems, insurance software, and relevant certifications such as Certified Professional Coder (CPC) are highly beneficial. Attention to detail, analytical thinking, and effective communication are essential soft skills for ensuring accuracy and resolving discrepancies. These skills and qualifications are crucial for minimizing errors, preventing fraud, and ensuring timely and compliant claim adjudication in a remote work environment.

What Does a Remote Medical Claims Examiner Do?

As a remote medical claims examiner, your primary responsibilities involve investigating health insurance claims. In this career, you work from home and assess patient insurance coverage information and eligibility. You speak with patients, doctors, and other involved parties to gain additional insight into each case. Your duties include taking steps to review each case and decide whether to pay the claim, negotiate a settlement, or deny the request. You make these decisions based on the data you collect and the policy of your employer. You also take steps to detect and defend against fraud.

What does a Remote Medical Claims Examiner do?

A Remote Medical Claims Examiner is responsible for reviewing and processing medical insurance claims from a remote location, often working from home. Their job involves evaluating medical records, verifying patient eligibility, checking the accuracy of billing codes, and determining whether claims should be approved, denied, or sent back for more information. They ensure that claims comply with insurance policies and regulatory guidelines, and may also communicate with healthcare providers or policyholders to clarify details. Working remotely requires strong attention to detail, good communication skills, and proficiency with specialized claims processing software.
More about Remote Medical Claims Examiner jobs
What cities are hiring for Remote Medical Claims Examiner jobs? Cities with the most Remote Medical Claims Examiner job openings:
What states have the most Remote Medical Claims Examiner jobs? States with the most job openings for Remote Medical Claims Examiner jobs include:
What job categories do people searching Remote Medical Claims Examiner jobs look for? The top searched job categories for Remote Medical Claims Examiner jobs are:
Remote Medical Claims Examiner jobs near you
Infographic showing various Remote Medical Claims Examiner 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 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.
Medical Claims Examiner

Medical Claims Examiner

Insperity

Los Angeles, CA • On-site, Remote

$20 - $25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 21 days ago

Insperity rating

7.8

Company rating: 7.8 out of 10

Based on 32 frontline employees who took The Breakroom Quiz

151st of 488 rated business services

Job description

General information
Client / Corporate
Client
Work Mode
Hybrid
Name
Medical Claims Examiner
Job ID
21986
City
Chatsworth (Local Remote)
Published date
07-Jul-2026
State
California
Country
United States
Zip Code
91311
Description & Requirements
Medical Claims Examiner
Local Remote or In-Office
Join a team where your attention to detail and commitment to quality care make a difference. Thrifty Management Services, the dedicated MSO for Preferred IPA of California, seeks a skilled and compassionate Medical Claims Examiner to help us deliver exceptional healthcare support. In this role, you will be responsible for the accurate and timely adjudication of CMS 1500 and UB-04 claims, ensuring compliance with Medicare and Medi-Cal guidelines. At Thrifty, we pride ourselves on our people-first culture that values teamwork, compassion, and work-life balance. If you're passionate about improving healthcare, we'd love to meet you.
Best-in-Class Benefits and Culture:
We value our employees' time and efforts. Our commitment to your success is enhanced by competitive compensation of $20-$25 per hour, depending on experience, and an extensive benefits package including:
  • Comprehensive health coverage: Medical, dental, and vision insurance provided
  • Robust retirement planning: 401(k) plan available with employer matching
  • Financial security: Life and disability insurance for added protection
  • Flexible financial options: Health savings and flexible spending accounts offered
  • Well-being and work-life balance: Paid time off, flexible schedule, and remote work choices provided

Plus, we work to maintain the best environment for our employees, where people can learn and grow with the company. We strive to provide a collaborative, creative environment where everyone feels encouraged to contribute to our processes, decisions, planning, and culture.
To thrive as the Medical Claims Examiner, you should have:
  • Minimum of 2 years of medical claims payment experience in an HMO environment (i.e., MSO, IPA, or health plan)
  • Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.
  • Experience with CPT-4, ICD-10-CM, RBRVS, ASA, and HCPCS, as well as an in-depth understanding of Medicare and Medi-Cal guidelines that apply to COB and Medicare Secondary Payer.
  • Extensive familiarity and experience in planning benefit and co-payment determination, division of financial responsibility determination, claims policies and procedures, adjudication processes, and claim review and analysis involving NCCI rules.
  • Extensive working knowledge of reimbursement methodologies for professional claims, including injectable drugs.

Ready to make your mark in healthcare?
Step into a pivotal role where your precision powers patient care! Thrifty Management Services is searching for passionate Claims Examiners who thrive on accuracy, efficiency, and impact. This is your moment if you're driven to ensure timely and accurate claims processing while supporting a people-first mission. Apply now and help us transform lives-one claim at a time!
We are an equal opportunity employer that welcomes and encourages diversity in the workplace. We do not discriminate based on race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.
Qualified applicants with arrest or conviction records will be considered for employment with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

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About Insperity

Sourced by ZipRecruiter

Take care of your people Insperity has a long history of improving the success equation of small and midsize businesses across the country – because when businesses succeed, communities prosper. And in today’s changing business environment, it’s our privilege to take care of an organization’s most valuable asset: its people.

Company size

1,001 - 5,000 Employees

Headquarters location

Houston, TX, US

Year founded

1986

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