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Remote Medical Claims Processing Jobs in Kentucky

BrightSpring

Medicare D Billing Representative

Louisville, KY · Remote

$15.75 - $20.25/hr

... Medical Billing experience Remote: May reside anywhere with the Continental USA. No matter what ... claims * Individual with an understanding of Insurance and Medicaid formularies and processes ...

PharMerica

Medicare D Billing Representative

Louisville, KY · On-site +1

$15.75 - $20.25/hr

... Medical Billing experience Remote: May reside anywhere with the Continental USA. No matter what ... claims * Individual with an understanding of Insurance and Medicaid formularies and processes ...

NTT DATA Services

Epic Analyst-REMOTE

Bowling Green, KY · Remote

$78K - $164K/yr

Handle incoming calls and follow account-specific processes. Understand the latest configurations ... This position is eligible for company benefits including medical, dental, and vision insurance with ...

New

NTT DATA Services

Epic Analyst-REMOTE

Bowling Green, KY · Remote

$78K - $164K/yr

Handle incoming calls and follow account-specific processes. Understand the latest configurations ... This position is eligible for company benefits including medical, dental, and vision insurance with ...

New

MCKESSON

Field Reimbursement Manager

Louisville, KY · On-site +1

Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ... medical necessity, claims and appeal assistance, information related to co-pay assistance and ...

New

MCKESSON

Field Reimbursement Manager

Lexington, KY · On-site +1

Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ... medical necessity, claims and appeal assistance, information related to co-pay assistance and ...

New

MCKESSON

Field Reimbursement Manager

Somerset, KY · On-site +1

Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ... medical necessity, claims and appeal assistance, information related to co-pay assistance and ...

New

MCKESSON

Field Reimbursement Manager

Florence, KY · On-site +1

Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ... medical necessity, claims and appeal assistance, information related to co-pay assistance and ...

New

MCKESSON

Field Reimbursement Manager

Richmond, KY · On-site +1

Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ... medical necessity, claims and appeal assistance, information related to co-pay assistance and ...

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

Remote Medical Claims Processing information

See Kentucky salary details

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

As of Aug 8, 2026, the average hourly pay for remote medical claims processing in Kentucky is $16.91, according to ZipRecruiter salary data. Most workers in this role earn between $15.05 and $18.80 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 Kentucky? For Remote Medical Claims Processing jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Remote Medical Claims Processing jobs in Kentucky look for? The top searched job categories for Remote Medical Claims Processing jobs in Kentucky are:
What cities in Kentucky are hiring for Remote Medical Claims Processing jobs? Cities in Kentucky 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 Kentucky as of August 2026, with employment types broken down into 83% Full Time, 9% Part Time, 4% Contract, and 4% Nights. Highlights an 100% Remote job distribution, with an average salary of $35,169 per year, or $16.9 per hour.

Medicare D Billing Representative

BrightSpring

Louisville, KY • Remote

$15.75 - $20.25/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 14 days ago

Job description

Our Company
PharMerica
Overview
PharMerica, a part of Brightspring Health Services, is a long-term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States.
The Medicare D Biller serves as a primary liaison for the Clinical Hub, maintaining proactive communication with pharmacists, healthcare facilities, physicians, and Prescription Drug Plans (PDPs) regarding therapeutic interchange opportunities and prior authorization requests. This role is responsible for researching payment denials by contacting insurance plans to determine the cause of denials and coordinating with facilities to obtain supporting information. Additionally, the Medicare D Biller updates and documents prior authorizations, including clinical justifications, while ensuring the accurate and timely completion of all required authorization forms.
The position requires a high level of attention to detail when initiating, processing, and tracking prior authorizations on behalf of customers. Working closely with EMAR systems, healthcare facilities, and clinical teams, the Medicare D Biller serves as a key point of contact throughout the prior authorization process, ensuring efficient coordination, thorough documentation, and successful resolution of authorization requests.
The ideal candiate will be a Certified Pharmacy Technician or Medical Assistant Certification (desired) and have Third party Medical Billing experience
Remote: May reside anywhere with the Continental USA.
No matter what time zone in which you reside, you must be able to work Central Time Zone hours
Schedule: Monday - Friday 11am - 7:30pm CENTRAL Time Zone
Benefits and perks for You!
  • Medical, Dental, Vision insurance
  • Health Savings & Flexible Spending Accounts (up to $5,000 for childcare)
  • Tuition discounts & reimbursement
  • 401(k)
  • Company Paid Time Off*
  • Shift Differential
  • DailyPay
  • Pet Insurance
  • Employee wellness and discount programs

Responsibilities
  • Act as a resource to the facilities in obtaining information completing necessary documentation or following up on outstanding claims
  • Individual with an understanding of Insurance and Medicaid formularies and processes including the prior authorization processes
  • Makes outgoing calls to Facilities, Plans, and Physician's offices as needed to obtain approvals
  • Works with Client Billing Service Offices, Pharmacy Directors, customers and prescription drug plans to effectively communicate and resolve customer issues
  • Performs other tasks as assigned
  • Achieves productivity goals with regard to calls/claims per hour as determined by the Director and Clinical Hub Manager
  • Provide clinical support to members of the RxAllow team regarding prior authorization concerns / submissions
  • Conducts job responsibilities in accordance with the standards set out in the Company's code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and State Laws, and applicable professional standards
  • Familiar with the claim adjudication process
  • Develop a strong understanding of the insurance verification, adjudication, back-end billing process and become a subject matter expert on the insurance queues and billing workflow

Qualifications
  • High School Diploma, Associates degree; Bachelor's degree preferred
  • Certified Pharmacy Technician or Medical Assistant Certification desired
  • Third party Medical Billing experience
  • EMAR system knowledge
  • One to three years of pharmacy experience preferred
  • Three years of call center experience preferred
  • Understanding of insurance and medicaid formularies and processes including the prior authorization processes
  • Familiar with the claim adjudication process
  • Proficiency in Microsoft Office programs
  • Prioritize work to meet daily and competing deadlines

About our Line of Business
PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.