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Remote Medical Claims Processing Jobs in Wisconsin

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Remote Medical Claims Processing information

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$14

$19

$25

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

As of Jun 16, 2026, the average hourly pay for remote medical claims processing in Wisconsin is $19.65, according to ZipRecruiter salary data. Most workers in this role earn between $17.45 and $21.83 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.

How much do remote medical billers make in the US?

Remote medical billers in the US typically earn between $15 and $25 per hour, with annual salaries ranging from approximately $30,000 to $52,000. Compensation varies based on experience, certifications, and the complexity of claims processed.

How can I make 70000 a year working from home?

Remote medical claims processing roles can pay up to $70,000 annually for experienced professionals. Achieving this salary typically requires strong attention to detail, knowledge of medical billing and coding, and proficiency with claims processing software. Gaining relevant certifications and working full-time or handling high-volume claims can help reach this income level.

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.

Do claims adjusters work remotely?

Many claims adjusters, including those in medical claims processing, work remotely, especially in companies that utilize digital tools and claim management software. Remote work allows for flexible schedules and the use of communication platforms like email and video conferencing, making it a common arrangement in the industry.

How to become a medical claim processor?

To become a medical claim processor, typically one needs a high school diploma or equivalent, along with training in medical billing and coding. Familiarity with healthcare management software and understanding of insurance policies are also important; some roles may require certification such as Certified Professional Coder (CPC).

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, and why are they important?

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 Wisconsin? For Remote Medical Claims Processing jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Remote Medical Claims Processing jobs in Wisconsin look for? The top searched job categories for Remote Medical Claims Processing jobs in Wisconsin are:
What cities in Wisconsin are hiring for Remote Medical Claims Processing jobs? Cities in Wisconsin with the most Remote Medical Claims Processing job openings:
Remote Medical Claims Processing jobs near you
Appeals Claims Processor

Appeals Claims Processor

WPS Health Solutions

Madison, WI • On-site, Remote

$19.60/hr

Full-time

Medical, Dental, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

WPS Health Solutions rating

8.3

Company rating: 8.3 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

111th of 261 rated insurance

Job description

U.S. citizenship is required for this position due to Department of Defense restrictions.


The Appeals Claims Processor is responsible for reviewing and making determinations on MVH appealable denials, from receipt through resolution in accordance with MVH regulations, guidelines, quality standards, and contractual requirements. The role works closely with the Nursing team to support and discuss medical decision-making.

 Additional Information

  • Start Date: June 30, 2026
  • Starting Hourly Rate: $19.60/hour and may vary based on county SCA rates.
  • Training Location/Schedule: On the job training – 1st Shift
  • Work Location: This is a 100% remote opportunity within any of our approved remote worker states.

We are open to remote work in the following approved states:
Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin

In this role you will:

  • Process Medical and Factual Appeals received by Providers, Beneficiaries and DHA.
  • Translate, research, and verify claims information to determine if all requirements have been met.
  • Accountable for CNOTE completion, Summary Log creation, calculation of amounts in dispute, and sending determination letters.
  • Review incoming Appeals mail to ensure it is being submitted to the appropriate team.
  • Initiate adjustments, reprocesses and serve as resource for other teams.
  • Access patient/sponsor files and update information accordingly.

Minimum Qualifications

  • U.S. citizenship is required for this position due to Department of Defense restrictions.
  • High School Diploma or GED or equivalent experience.
  • 1 or more years of experience in a claims processing role.
  • Knowledge of TRICARE Policy Manuals and eligibility guidelines, claims adjudication procedures and MVH system programs.
  • Ability to effectively utilize available resources to further research and verify claims.
  • Strong written communication skills.
  • Demonstrates the ability to work independently and take initiative.

 Preferred Qualifications

  • 2 or more years of experience as a TRICARE Customer Service Representative or a Claims Processor.

Remote Work Requirements

  • Wired (ethernet cable) internet connection from your router to your computer
  • High speed cable or fiber internet
  • Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net)
  • Please review Remote Worker FAQs for additional information

Benefits

  • Remote work options available
  • Performance bonus and/or merit increase opportunities
  • 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
  • Competitive paid time off
  • Health insurance, dental insurance, and telehealth services start DAY 1
  •  Employee Resource Groups
  • Professional and Leadership Development Programs
  •  Review additional benefits: (https://www.wpshealthsolutions.com/careers/)

Who We Are

WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.

Culture Drives Our Success

WPS’ culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.

We are proud of the recognition we have received from local and national organization regarding our culture and workplace:  WPS Newsroom - Awards and Recognition.

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This position supports services under U.S. Department of Defense (DoD) Defense Health Agency (DHA) contract(s).  As such, the role is subject to all applicable federal regulations, DoD contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity.  DoD contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services.

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