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Remote Medical Claims Processing Jobs in Massachusetts

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Director Casualty Claims

Itasca, IL · On-site +1

This position offers full remote or hybrid flexibility out of our Chicago, IL office. IN THIS ROLE ... Develop and execute key strategic initiatives and operational processes to drive improved claim ...

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Director Casualty Claims

Itasca, IL · On-site +1

This position offers full remote or hybrid flexibility out of our Chicago, IL office. IN THIS ROLE ... Develop and execute key strategic initiatives and operational processes to drive improved claim ...

Liberty Mutual

Environmental Claims Officer

MA · On-site +1

We will also consider highly qualified remote candidates who do not reside near a hub location ... Support audit and compliance processes while maintaining required adjuster licenses and ...

Careforth

Medical Billing Specialist

Boston, MA · Remote

$19.75 - $25.50/hr

Gather all information necessary to process consumer insurance claims; ensure billing accounts ... With flexible schedules, a remote-first culture, and a nationally recognized wellness program, our ...

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

Remote Medical Claims Processing information

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 Massachusetts? For Remote Medical Claims Processing jobs in Massachusetts, the most frequently searched job titles are:
What job categories do people searching Remote Medical Claims Processing jobs in Massachusetts look for? The top searched job categories for Remote Medical Claims Processing jobs in Massachusetts are:
What cities in Massachusetts are hiring for Remote Medical Claims Processing jobs? Cities in Massachusetts 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 Massachusetts as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution.

Claims Senior MedPay Adjuster

American Automobile Association (AAA)

Boston, MA • Remote

$35.94 - $47.87/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 2 days ago

AAA The Auto Club Group rating

7.5

Company rating: 7.5 out of 10

Based on 282 frontline employees who took The Breakroom Quiz

217th of 304 rated insurance

Job description

Claims Senior MedPay Adjuster

Job Summary
The Claims Senior Medpay Adjuster handles moderate to high complexity Auto claims matters involving material damage, property and / or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include liability investigation, coverage evaluation, and negotiation of moderate to high-complexity claims. Employs discretion and independent judgment to ensure compliance with state and federal law, and with established company, technical, and customer service best practices.
Job Duties

  • Communicate and interact with a variety of individuals including insureds and claimants. Explain benefits, coverages, fault and claims process either verbally or in writing in compliance with regulatory and statutory requirements. Recognize and appropriately address coverage issues.
  • Conduct phone investigations to determine liability and damages. Identify and obtain statements from insureds, claimants and witnesses. Verify and resolve coverage by gathering necessary information to ensure policy applicability.
  • Evaluate and determine claim values upon receipt and assessment of property, bodily injury and liability data.
  • Negotiate within settlement authority with insureds and claimants to resolve first and third party claims.
  • Update database production reports, document and update claim files via company systems, i.e. CACS, HUON, HOC, GUIDEWIRE, etc.
  • Control expenses for areas of responsibility.
  • Verify and interpret / resolve coverage by gathering necessary information to ensure policy applicability. Coordinate with internal and external departments as required.
  • Independently resolve claim exposures within level of authority.
  • Respond quickly to customer needs and problems.
  • May attend and participate in legal proceedings.


Qualifications

  • Bachelors Equivalent combination of education and experience Preferred
  • 7-9 years Prior claims handling experience. Required
  • 7-9 years Property, Auto, Casualty or relevant claims administration experience. Preferred
  • Comprehensive knowledge of claims administration best practices and procedures.
  • Comprehensive knowledge of building and vehicle repair procedures and third-party liability issues.
  • Extensive knowledge of insurance, fault assessment, negligence and subrogation principles required.
  • Advanced knowledge of Microsoft Office suite, general computer software and claims software.
  • Advanced organization and planning recognition skills required.
  • Advanced oral and written communication skills required.
  • Advanced interpersonal skills required.
  • Advanced leadership skills among peers required.
  • Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required
  • An insurance/claims adjuster license may be required for claims administration in specific states.


Travel Requirements

  • Occasional travel to off-site business meetings or conferences. (5% proficiency)

The starting pay range for this position is $35.94 - $47.87 per hour. Additionally, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance.

Remarkable benefits:

Health coverage for medical, dental, vision

401(K) saving plans with company match AND Pension

Tuition assistance

Floating holidays and PTO for community volunteer programs

Paid parental leave

Wellness programs

Employee discounts (membership, insurance,

travel, entertainment, services and more!)

Auto Club Enterprises is the largest club within the national AAA federation. We have nearly 17,000 employees in 24 states helping more than 18 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity - we win. All of Us! With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

"Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value."

AAA is an Equal Opportunity Employer

Our organization participates in E-Verify

What AAA The Auto Club Group employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

American Automobile Association logo

About American Automobile Association

Sourced by ZipRecruiter

The American Automobile Association (AAA), headquartered in Heathrow, Florida, USA, is a reputable force in the automotive and insurance industry. Originating in 1902, it began as a coalition of motor clubs with the common goal of providing better roads and travel conditions for motorists. Today, AAA is a comprehensive, multifaceted organization that offers a range of services, including roadside assistance, auto repair services, travel agency services, and diverse insurance products - Auto, Home, Life and more. A significant principle for AAA is to continuously deliver value to their 61 million members through safety, security and peace of mind. The company's mission and core values focus on championing its members' rights and interests, advocating innovation, integrity, teamwork and respect.

Industry

Non-profits

Company size

10,000+ Employees

Headquarters location

Heathrow, FL, US

Year founded

1902

Social media

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