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Remote Medical Claims Processor Jobs in Caledonia, MI

USAA

Sr. TLE Auto Appraiser

Grand Rapids, MI · On-site +1

$63K - $121K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Maintains accurate and current claim file documentation throughout the claims process for complex ...

Deloitte

Epic Denials Manager

Grand Rapids, MI · Remote

... process accounts and claims. Regularly monitors work queues and workflows in Epic, claims ... This is a remote role with minimal travel requirements. A successful candidate would possess these ...

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Deloitte

Epic Denials Management Operator

Grand Rapids, MI · Remote

$17.25 - $23/hr

... Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...

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All JobsMedical Claims Processor JobsRemote Medical Claims Processor JobsRemote Medical Claims Processor Jobs in Caledonia, MI

Remote Medical Claims Processor information

See Caledonia, MI salary details

$13

$18

$24

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

As of Aug 26, 2026, the average hourly pay for remote medical claims processor in Caledonia, MI is $18.59, according to ZipRecruiter salary data. Most workers in this role earn between $16.54 and $20.67 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 Caledonia, MI are hiring for Remote Medical Claims Processor jobs?

Cities near Caledonia, MI with the most Remote Medical Claims Processor job openings:

Remote Medical Claims Processor jobs near you

Claims Operations Associate II

Great American Insurance Group

Wyoming, MI • Remote

$20 - $27/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 17 days ago

Great American Insurance Group rating

8.8

Company rating: 8.8 out of 10

Based on 31 frontline employees who took The Breakroom Quiz

56th of 312 rated insurance

Job description

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.

At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.

This position is not eligible for employment visa sponsorship. Applicants must be authorized to work in the United States without the need for current or future sponsorship.

Who We Are

Strategic Comp is a leading provider of workers' compensation insurance for large employers committed to protecting their workforce. As part of Great American, we combine the strength and stability of a trusted organization with more than 150 years of history with the entrepreneurial spirit of a growing business.

Through our specialized insurance expertise and field-based service model, we build lasting partnerships and deliver exceptional results for our customers. Our culture is built on collaboration, excellence, and a shared commitment to serving our customers and one another.

Position Overview

The Claims Operations Associate II provides operational and administrative support to workers' compensation claims professionals, helping ensure claims are set up, maintained, and processed accurately and efficiently. This role serves as a key partner to adjusters by handling claim-related transactions, correspondence, documentation, and customer inquiries while maintaining high standards of service and accuracy. The position requires strong organizational skills, attention to detail, and the ability to manage multiple priorities in a fast-paced environment.

This is a remote, work-from-home position for candidates located within the Mountain or Central Time Zone and available to work 37.5 hours per week, Monday through Friday from 8:00 a.m. to 4:30 p.m. Mountain/Central Time.

Responsibilities

  • Provide operational support to workers' compensation adjusters by managing claim-related administrative activities.

  • Set up and maintain claim files, ensuring information is entered accurately and updated in a timely manner.

  • Verify coverage, process claim-related transactions, and support payment and financial processing activities.

  • Respond to inquiries received by phone, email, and voicemail, resolving routine issues and escalating complex matters as appropriate.

  • Utilize problem-solving and investigative skills to gather information, identify discrepancies, and support issue resolution.

  • Prepare and distribute correspondence, forms, and other claim-related documentation.

  • Coordinate phone outreach to collect information, schedule appointments, and support claim file development.

  • Assist with litigation support by organizing and providing required claim documentation.

  • Maintain organized workloads and activities through systems such as ClaimConnect, ClaimCenter, OpsNow, Outlook, and other claims platforms.

  • Support policy, claim, and data management processes to ensure accuracy and compliance with established procedures.

  • Collaborate effectively with adjusters, internal departments, and external contacts to facilitate claim handling activities.

  • Maintain professionalism and confidentiality in all interactions and communications.

  • Meet productivity, quality, and service expectations while managing multiple priorities.

  • Follow established guidelines and procedures while seeking guidance on complex or non-routine issues.

Qualifications

  • High school diploma or equivalent required.

  • Experience in claims operations, claims processing, claims support, or a related insurance administrative role required.

  • Experience supporting workers' compensation adjusters or claims professionals strongly preferred.

  • Strong verbal and written communication skills with the ability to interact professionally with internal and external stakeholders.

  • Demonstrated ability to work accurately, manage multiple tasks, and maintain attention to detail in a fast-paced environment.

  • Must be located within the Mountain or Central Time Zone and able to work standard business hours in those time zones.

Business Unit:

Strategic Comp


Salary Range:

$20.00 -$27.00

Benefits:

We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.

Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.

*Excludes seasonal employees and interns.

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