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Remote Medical Claims Processor Jobs in Kentucky

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... remote, giving you the freedom to work from anywhere! What You'll Do: As a dynamic Claims ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... remote, giving you the freedom to work from anywhere! What You'll Do: As a dynamic Claims ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... remote, giving you the freedom to work from anywhere! What You'll Do: As a dynamic Claims ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... remote, giving you the freedom to work from anywhere! What You'll Do: As a dynamic Claims ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

Sutherland

Health Claims Specialists

Louisville, KY · On-site +1

$13.50/hr

This is a data entry position where you will be processing medical claims per the specific client requirements. Claims can vary and are highly customized depending on the service level. You will work ...

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$12

$16

$22

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

As of Aug 27, 2026, the average hourly pay for remote medical claims processor 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 a remote medical claims processor?

Remote medical claims processors handle billing paperwork for health care offices or insurance companies. Instead of working in the office, remote medical claims processors complete their job duties from home or another location outside of the office with internet connectivity. As a remote medical claims processor, your responsibilities include ensuring medical insurance claims have proper billing codes that match the services provided, clarifying patient concerns about benefits, and adding changes made to the claim by the doctors or insurer. You may also be required to follow up with the insurer to find out the status of claims and discuss any discrepancies.

What does a remote medical claims processor do?

A Remote Medical Claims Processor reviews, evaluates, and processes insurance claims submitted by healthcare providers and patients. Working from a remote location, they verify the accuracy of claim information, ensure proper coding, and determine whether services are covered based on insurance policies. They also communicate with providers, patients, and insurance companies to resolve discrepancies or request additional information. This role helps ensure that claims are processed efficiently and accurately for timely reimbursement.

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

To thrive as a Remote Medical Claims Processor, a solid understanding of medical terminology, insurance policies, and claims adjudication is essential, typically supported by a high school diploma or equivalent and relevant experience. Familiarity with claims management software, electronic health records (EHR) systems, and knowledge of HIPAA regulations are typically required. Attention to detail, strong organizational skills, and clear written communication help individuals excel in processing claims accurately and efficiently. These skills ensure timely and correct claims processing, reducing errors and supporting the financial health of both healthcare providers and patients.

How does a remote medical claims processor typically collaborate with healthcare providers and insurance companies while working from home?

As a Remote Medical Claims Processor, collaboration with healthcare providers and insurance companies primarily occurs through secure digital communication channels, such as email, specialized claims management software, and phone calls. You will regularly interact with provider offices to clarify patient information, verify coverage, or resolve discrepancies in submitted claims. While the role is independent, you often coordinate with team members and supervisors virtually to ensure claims are processed efficiently and accurately. Maintaining clear documentation and communication is essential for resolving issues and minimizing processing delays.

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

AspectRemote Medical Claims ProcessorRemote Medical Billing Specialist
CredentialsTypically requires medical coding or claims processing certificationsOften requires medical billing certifications and coding knowledge
Work EnvironmentRemote, healthcare or insurance companiesRemote, healthcare providers or billing companies
Industry UsageInsurance companies, third-party administratorsHospitals, clinics, billing service providers
Job FocusProcessing and reviewing insurance claims for reimbursementPreparing and submitting bills, managing accounts receivable

While both roles work remotely within the healthcare industry, the Remote Medical Claims Processor primarily reviews and processes insurance claims, focusing on reimbursement. In contrast, the Remote Medical Billing Specialist handles billing procedures, including preparing and submitting invoices. Both roles require similar certifications and often overlap in work environment and employer types, but their core responsibilities differ in claim review versus billing management.

More about Remote Medical Claims Processor jobs

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For Remote Medical Claims Processor jobs in Kentucky, the most frequently searched job titles are:

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Remote Medical Claims Processor jobs near you
Infographic showing various Remote Medical Claims Processor job openings in Kentucky as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 17% Part Time, and 6% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $35,169 per year, or $16.9 per hour.

Pharmacy Claims Processor / Remote

Louisville, KY • Remote

BrightSpring Health Services
Health Care and Social Assistance • 10K+ employees

4.9

Company rating: 4.9 out of 10

Based on 64 frontline employees who took The Breakroom Quiz

221st of 243 rated social care providers

People enjoy working here

Respectful managers

Uninterrupted breaks

Learn more about BrightSpring Health Servicesexternal

$20 - $23/hr

Full-time

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

Job description

Overview

Step Into a Rewarding Role as a Claims Specialist with PharMerica!

Are you ready to make a real impact in a growing organization? Join our PharMerica team as a Claims Specialist, where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy environment, allowing you to focus on what truly matters—delivering exceptional care and service.

Why Join PharMerica?

  • Focused on Service Excellence: Our mission is to provide top-quality care and outstanding customer service to hospitals, rehabilitation centers, long-term acute care hospitals, and specialized care centers across the nation.
  • Career Growth: We’re in high growth mode, offering plenty of opportunities for those looking to advance their careers.
  • Remote Flexibility: This position is 100% remote, giving you the freedom to work from anywhere!

What You’ll Do: As a dynamic Claims Specialist, you will:

  • Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need.
  • Be a vital part of a team that’s dedicated to enhancing patient care through meticulous claims management and customer service.

What We Offer:

  • DailyPay
  • Flexible Schedules
  • Competitive Pay with Shift Differentials
  • Health, Dental, Vision, and Life Insurance
  • Company-Paid Disability Insurance
  • Tuition Assistance & Reimbursement
  • Employee Discount Program
  • 401k Plan
  • Paid Time Off
  • Non-Retail, Closed-Door Environment

Responsibilities

The Claims Specialist - 3rd Party:

  • Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks
  • Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines
  • Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement
  • Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes
  • Works as a team to identify, document, communicate and resolve payer/billing trends and issues
  • Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans
  • Prepares and maintains reports and records for processing
  • Performs other tasks as assigned

Qualifications

Education/Learning Experience:

  • Required: High School Diploma or GED
  • Desired: Associate’s or Bachelor’s Degree

Work Experience:

  • Required: Customer Service
  • Desired: Up to one year of related experience. Pharmacy Technician experience

Skills/Knowledge:

  • Required: Ability to retain a large amount of information and apply that knowledge to related situations. Ability to work in a fast-paced environment. Basic math aptitude. Microsoft Office Suite
  • Desired: Knowledge of the insurance industry’s trends, directions, major issues, regulatory considerations and trendsetters

Licenses/Certifications:

  • Desired: Pharmacy technician, but not required

What BrightSpring Health Services employees say

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Benefits

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