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Remote Medical Claims Processing Jobs in California

Molina Healthcare

Senior Examiner, Claims

Long Beach, CA · Remote

$18.50 - $23.50/hr

... processing errors. Manages a caseload of claims - procures all medical records and statements that support the claim. Makes recommendations for further investigation and/or resolution of claims.

Allcat Claims Service

Claims Examiner

Los Angeles, CA · On-site +1

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.

WellPsyche

Claims Follow-Up Lead-CA

Los Angeles, CA · Remote

$25 - $30/hr

... Organization | Remote WellPsyche Medical Group is a leading telehealth behavioral health ... Participate in process improvements in a fast-moving environment. * Possess qualities supporting ...

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All JobsMedical Claims Processing JobsRemote Medical Claims Processing JobsRemote Medical Claims Processing Jobs in California

Remote Medical Claims Processing information

See California salary details

$13

$19

$25

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

As of Aug 16, 2026, the average hourly pay for remote medical claims processing in California is $19.21, according to ZipRecruiter salary data. Most workers in this role earn between $17.07 and $21.35 per hour, depending on experience, location, and employer.

What is the difference between Remote Medical Claims Processing vs Remote Medical Billing Specialist?

AspectRemote Medical Claims ProcessingRemote Medical Billing Specialist
CredentialsKnowledge of insurance policies, claims processing certifications often preferredMedical billing certifications, coding credentials like CPC or CCS+
Work EnvironmentHome-based, computer-focused, insurance company or third-party payerHome-based, healthcare provider offices, billing companies
Industry UsageInsurance companies, third-party administratorsHospitals, clinics, medical practices
Search & Comparison IntentFocus on claims processing tasks, insurance reimbursementFocus on billing, coding, and invoicing processes

Remote Medical Claims Processing involves reviewing and submitting insurance claims for reimbursement, often requiring knowledge of insurance policies. Remote Medical Billing Specialists handle invoicing and coding for healthcare providers. While both roles are home-based and involve healthcare finance, claims processing emphasizes insurance submission, whereas billing focuses on patient invoicing and coding accuracy.

What is remote medical claims processing?

Remote medical claims processing involves reviewing, validating, and submitting health insurance claims from a location outside of a traditional office, often from home. Professionals in this role analyze patient data, ensure claims are accurate and complete, and handle communication with insurance companies to facilitate timely reimbursement. This job requires strong attention to detail, knowledge of medical terminology and billing codes, and proficiency with healthcare management software. Many employers offer remote positions to streamline operations and accommodate flexible work arrangements.

How to get a job as a remote medical claims processing?

To get a remote medical claims processing job, candidates typically need a high school diploma or equivalent, strong attention to detail, and familiarity with medical billing and coding software. Relevant certifications such as CPC or CCS can improve job prospects, and experience with electronic health records (EHR) systems is often preferred. Applying through healthcare companies, insurance providers, or staffing agencies that specialize in remote roles is common.

What are some common challenges faced when working remotely as a medical claims processor, and how can they be managed?

Remote medical claims processors often face challenges such as maintaining clear communication with team members, managing a high volume of claims efficiently, and staying updated on frequently changing insurance policies. To manage these challenges, it's important to utilize collaboration tools, participate in regular virtual meetings, and establish a structured daily routine. Additionally, leveraging secure digital resources and ongoing training can help ensure accuracy and compliance, making remote work both productive and rewarding.

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

To thrive as a Remote Medical Claims Processor, you need a strong understanding of medical terminology, insurance policies, and claims adjudication, typically supported by a high school diploma or an associate degree in health administration. Proficiency with claims management software, electronic health record (EHR) systems, and familiarity with coding systems like ICD-10 and CPT is essential. Attention to detail, time management, and effective written communication are standout soft skills in this role. These skills and qualities ensure accurate, efficient claims processing and help maintain compliance with healthcare regulations.

What are popular job titles related to Remote Medical Claims Processing jobs in California?

For Remote Medical Claims Processing jobs in California, the most frequently searched job titles are:

What job categories do people searching Remote Medical Claims Processing jobs in California look for?

The top searched job categories for Remote Medical Claims Processing jobs in California are:

What cities in California are hiring for Remote Medical Claims Processing jobs?

Cities in California with the most Remote Medical Claims Processing job openings:

Remote Medical Claims Processing jobs near you
Infographic showing various Remote Medical Claims Processing job openings in California as of August 2026, with employment types broken down into 1% As Needed, 69% Full Time, 23% Part Time, 2% Temporary, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $39,963 per year, or $19.2 per hour.

Physician Medical Director - Competitive Salary

Inspire Healthcare

San Diego, CA • Remote

$250K - $350K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 26 days ago

Job description

We are seeking a Remote Medical Director for a non-clinical role focused on prior authorization and medical necessity reviews. No direct patient care is required. Candidates must reside in the San Diego area and be available for occasional on-site meetings and trainings.

Responsibilities
  • Review prior authorization requests and determine medical necessity using evidence-based clinical guidelines.
  • Approve, deny, modify, or redirect services as appropriate.
  • Collaborate with nurses, physicians, and care management teams to support high-quality, cost-effective care.
  • Participate in appeals, grievance reviews, retrospective claims reviews, and quality improvement initiatives.
  • Serve as a clinical resource to providers on utilization management and patient care issues.
Qualifications
  • MD or DO degree required.
  • Board Certification in Internal Medicine strongly preferred.
  • Minimum 5 years of clinical experience required.
  • 2+ years of managed care, health plan, or utilization management experience preferred.
  • Strong knowledge of prior authorization processes and medical necessity criteria.
  • Excellent communication, organizational, and decision-making skills.
  • Proficiency with Microsoft Office and remote work technology.
Compensation & Benefits
  • Salary: $250,000"$350,000 annually DOE.
  • Comprehensive benefits package including medical, dental, vision, 401(k), paid time off, life insurance, FSA, tuition reimbursement, CME/license reimbursement, and employee assistance programs.

This is an excellent opportunity to join one of Southern California's fastest-growing physician organizations in a leadership role that supports quality patient care while maintaining work-life balance.

Apply