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Remote Medical Claims Processor Jobs in Beloit, WI

IME RESOURCES LLC

$28.50/hr

Why nurses love this role: * 100% Remote - Skip the commute and work from home * Work-Life Balance ... Must have strong knowledge of medical terminology, anatomy and physiology, medications and ...

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Remote Medical Claims Processor information

See Beloit, WI salary details

$13

$19

$25

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

As of Sep 6, 2026, the average hourly pay for remote medical claims processor in Beloit, WI is $19.04, according to ZipRecruiter salary data. Most workers in this role earn between $16.92 and $21.15 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

What cities near Beloit, WI are hiring for Remote Medical Claims Processor jobs?

Cities near Beloit, WI with the most Remote Medical Claims Processor job openings:

Remote Medical Claims Processor jobs near you
Infographic showing various Remote Medical Claims Processor job openings in Beloit, WI as of August 2026, with employment types broken down into 87% Full Time, 9% Part Time, and 4% Contract. Highlights an 100% Remote job distribution, with an average salary of $39,603 per year, or $19 per hour.

Clinical Quality Assurance Coordinator (32714)

ExamWorks LLC

Rockford, IL • On-site, Remote

$26.50 - $28.50/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 19 days ago

ExamWorks rating

8.0

Company rating: 8.0 out of 10

Based on 23 frontline employees who took The Breakroom Quiz

Job description

Ready to use your clinical expertise in a whole new way?
If you're a Registered Nurse (RN) who thrives on critical thinking, attention to detail, and uncovering the story behind the medical record, ExamWorks has an exciting opportunity for you.
We're looking for a Clinical Quality Assurance Coordinator to join our growing team. In this role, you'll analyze medical records, identify the most important clinical information, and craft clear, accurate summaries that make an impact.
Why nurses love this role:
*100% Remote - Skip the commute and work from home
*Work-Life Balance - Monday-Friday, 7:30am-4:00pm CT
*Use Your Clinical Knowledge Differently - Apply your nursing expertise beyond direct patient care
*Grow With Us - Supportive leadership, strong benefits, and opportunities for advancement
If you're looking for a rewarding next chapter where your clinical judgment and attention to detail truly shine, we'd love to connect.
Other responsibilities may include:
  • Perform quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
  • Ensure clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.
  • Ensure that all client instructions and specifications have been followed and that all questions have been addressed.
  • Ensure each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications.
  • Ensure the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.
  • Ensure the appropriate board specialty has reviewed the case in compliance with client specifications or state mandates and is documented accurately on the case report.
  • Verify that the peer reviewer has attested to only the facts and that no evidence of reviewer conflict of interest exists.
  • Ensure the provider credentials and signature are adhered to the final report.
  • Identify any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.
  • Assist in resolution of client complaints and quality assurance issues as needed.
  • Ensure all federal ERISA and state mandates are adhered to at all times.
  • Provide insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications.
  • Promote effective and efficient utilization of company resources.
  • Participate in various educational and or training activities as required.
  • Perform other duties as assigned.

  • Nursing license.
  • Professional writing experience preferred.
  • Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
  • Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages.
  • Must be a qualified typist with a minimum of 40 W.P.M preferred.
  • Must be able to operate a general computer, fax, copier, scanner, and telephone.
  • Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
  • Must possess excellent skills in English usage, grammar, punctuation and style.
  • Ability to follow instructions and respond to upper managements' directions accurately.
  • Must demonstrate accuracy and thoroughness. Look for ways to improve and promote quality and monitors own work to ensure quality is met.
  • Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
  • Must be able to work independently, prioritize work activities and use time efficiently.
  • Must be able to maintain confidentiality.
  • Must be able to demonstrate and promote a positive team -oriented environment.

ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.
ExamWorks, LLC is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws.
ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

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About ExamWorks

Sourced by ZipRecruiter

ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Atlanta, GA, US

Year founded

2008

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