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Remote Medical Claims Examiner Jobs (NOW HIRING)

TEEMA Group

$85K - $95K/yr

Remote Proficiency: Ability to work productively and independently in a fast-paced, 100% remote ... Full suite of premium benefits, including medical, dental, vision, and Paid Time Off (PTO)

Berkley

AVP, Sr. Claims Examiner

Manhattan, NY · Remote

$132K - $189K/yr

Responsibilities The AVP, Senior Claims Examiner handles all aspects of claims notices and files ... remote Key functions include but are not limited to: * Adjusting all aspects of claims and loss ...

woodmenlife

Claims Examiner I or II

Claims Examiner I or II This position could be hybrid or possibly fully remote depending on level of experience. WoodmenLife is looking to hire Claims Examiner I or II to join our team! In this role ...

Firstsource

Claims Examiner

$17 - $20/hr

United States (Remote) Employment Type: Full-Time Experience Required: Minimum 2 years in US Health ... Review, validate, and process medical, behavioral health, and pharmacy claims in accordance with ...

Firstsource

Claims Examiner

$17 - $20/hr

United States (Remote) Employment Type: Full-Time Experience Required: Minimum 2 years in US Health ... Review, validate, and process medical, behavioral health, and pharmacy claims in accordance with ...

RENFROE (Roster)

Commercial Claims Examiner

The Commercial Claims Examiner is responsible for approving and settling commercial property claims from the field where an estimate of damage has been prepared, or for preparing and settling ...

Markel International

Claims Examiner

Richmond, VA · On-site +1

$62K - $85K/yr

The national average salary range for the Claims Examiner positionis $62,000 - $85,800 with 12 ... medical condition; citizenship status; pregnancy, childbirth, or related medical conditions ...

Markel International

Claims Examiner

Omaha, NE · On-site +1

$62K - $85K/yr

The national average salary range for the Claims Examiner positionis $62,000 - $85,800 with 12 ... medical condition; citizenship status; pregnancy, childbirth, or related medical conditions ...

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Remote Medical Claims Examiner information

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$15

$29

$45

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

As of Aug 18, 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.

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.

What are the key skills and qualifications needed to thrive as a remote medical claims examiner?

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.

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.

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 August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

Commercial Auto & General Liability Claims Examiner II

TEEMA Group

Remote

$85K - $95K/yr

Full-time

Medical, Dental, Vision, PTO

Re-posted 27 days ago

Job description

Commercial Auto & General Liability Claims Examiner IIRole Summary

Empower your professional journey in a role that values intellectual curiosity and file ownership over high-volume "churn." As a Claims Examiner II, you will manage and resolve complex Commercial Auto, No-Fault/PIP, and General Liability claims from initial intake through final disposition. This position is perfect for a strategic thinker who excels at evaluating exposure, guiding investigative strategy, and collaborating with legal counsel to achieve fair and efficient resolutions. You will join a stable, rapidly growing organization that prides itself on autonomy, high-quality claims administration, and a professional work environment.

Key Duties:

  • Technical Policy Analysis: Review and interpret complex insurance policies to accurately determine liability and coverage exposure.

  • Comprehensive Claims Management: Independently investigate and evaluate Commercial Auto, PIP, and General Liability claims to ensure high-quality outcomes.

  • Litigation Oversight: Direct and coordinate efforts with outside investigators, legal counsel, and various vendors to drive claim strategy.

  • Financial Management: Evaluate total claims exposure to establish and maintain appropriate financial reserves.

  • Negotiation & Settlement: Develop and execute sophisticated settlement strategies and communicate recommendations to key stakeholders.

  • Strategic Reporting: Prepare detailed loss reports that synthesize liability, damages, and coverage issues.

  • Recovery Initiatives: Identify and pursue subrogation and risk transfer opportunities to protect client interests.

  • Professional Communication: Provide elite-level service and maintain transparent communication with both internal and external stakeholders.

Required Qualifications

  • Experience: 2+ years of dedicated experience handling Commercial Auto and General Liability claims.

  • Technical Mastery: Strong understanding of claims handling practices, coverage analysis, and litigation management.

  • Communication: Exceptional written and verbal communication skills.

  • Decision Making: Proven ability to evaluate complex data, make independent decisions, and negotiate effectively.

  • Organizational Skills: Superior time management skills and proficiency with claims management software and standard computer applications.

Desired Qualifications

  • Specialized Expertise: Direct experience managing No-Fault/PIP claims.

  • Education: Bachelor’s degree or equivalent professional experience.

  • Jurisdictional Knowledge: Familiarity with multi-jurisdictional claims handling requirements.

  • Remote Proficiency: Ability to work productively and independently in a fast-paced, 100% remote environment.

Location and Work Type

  • Location: 100% Fully Remote

  • Work Type: Full-Time | Direct Hire

  • Schedule: Standard Business Hours

  • Benefits: Full suite of premium benefits, including medical, dental, vision, and Paid Time Off (PTO).