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Remote Medical Claims Processor Jobs in Cayce, SC

CEI

RN/Managed Care Coordinator - Remote

Columbia, SC · Remote

Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare ... Performs medical or behavioral review/authorization process. Ensures coverage for appropriate ...

micro1 AI

Medical Writing Manager

Columbia, SC · Remote

$50 - $80/hr

Remote micro1 is engaging Medical Writers / Clinical Document Authors to participate in a customer ... Trace narrative claims to source records--tables, figures, listings, and protocols--to verify that ...

micro1 AI

Medical Billing Specialist

Columbia, SC · Remote

$50 - $80/hr

Remote micro1 is engaging Medical Writers / Clinical Document Authors to participate in a customer ... Trace narrative claims to source records--tables, figures, listings, and protocols--to verify that ...

Veristat

Principal Medical Writer

Columbia, SC · On-site +1

Benefits vary by location and may include: o Remote working o Flexible time off o Paid holidays o ... Veristat does not utilize an automated decision-making process. Veristat is an equal opportunity ...

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All JobsMedical Claims Processor JobsRemote Medical Claims Processor JobsRemote Medical Claims Processor Jobs in Cayce, SC

Remote Medical Claims Processor information

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

As of Aug 22, 2026, the average hourly pay for remote medical claims processor in Cayce, SC is $18.09, according to ZipRecruiter salary data. Most workers in this role earn between $16.11 and $20.10 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 Cayce, SC are hiring for Remote Medical Claims Processor jobs?

Cities near Cayce, SC 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 Cayce, SC as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 18% Part Time, and 6% Contract. Highlights an 88% Physical, 1% Hybrid, and 11% Remote job distribution, with an average salary of $37,631 per year, or $18.1 per hour.

Patient Billing Representative

Five Star Solutions

Columbia, SC • Remote

$14/hr

Full-time

Posted yesterday

New

Job description

Join us as a Patient Billing Specialist, where you’ll support patients with payment processing, billing education, insurance verification, and claims-related inquiries. This role delivers empathetic, accurate, and compliant service while navigating healthcare billing systems and policies. Agents perform all payment processing and payment plan functions in addition to advanced billing, insurance, and claims support.

This is a remote position for those that reside in = AL, GA, ID, IA, IN, KS, LA, MI, MS, NV, NC, ND, OH, OK, PA, SC, SD, TX, TN, UT, VA, WV, WI, WY

Qualifications
  • Customer service or call center experience required.
  • Healthcare billing, insurance, or claims experience strongly preferred.
  • Payment processing or financial transaction experience preferred.
  • High school diploma or GED required; additional billing or healthcare education a plus.
  • Technical proficiency with EMR systems and standard computer applications.
  • Ability to work independently in a remote or virtual environment.
  • Must be able to speak, read, write, and understand English.
  • Background check required in accordance with applicable laws.
Essential Functions

These functions emphasize patient advocacy, analytical billing expertise, regulatory awareness, and high-quality service delivery.

Patient Payment & Account Support

  • Accurately process patient payments via phone in accordance with Privia financial responsibility policies.
  • Create, update, and maintain payment plans following established guidelines.
  • Ensure transaction accuracy, proper documentation, and data integrity.

Billing, Insurance & Claims Support

  • Interpret and clearly explain claim notes, balances, and billing outcomes to patients.
  • Verify, audit, and update insurance information for completeness and accuracy.
  • Add or update insurance data within the EMR and resubmit pending or corrected claims.
  • Educate patients on billing concepts including coordination of benefits, deductibles, coinsurance, copays, timely filing, and claim denials.
  • Identify discrepancies and coordinate with internal teams to resolve billing-related issues.

Problem Resolution & Patient Education

  • Research account history to determine the root cause of billing or payment concerns.
  • Recommend appropriate resolutions and next steps in alignment with Privia policies.
  • Maintain professionalism and empathy during complex or sensitive financial discussions.

Resource & System Utilization

  • Utilize Privia-approved billing systems, EMR platforms, tools, and knowledge resources.
  • Navigate multiple systems simultaneously while assisting patients.
  • Adhere to all documentation, privacy, and security requirements.

Reliability & Continuous Learning

  • Maintain schedule adherence and consistent availability during assigned hours.
  • Complete all required Privia and client-mandated training.
  • Participate in ongoing uptraining and cross-training initiatives.

Ethical & Compliant Conduct

  • Uphold HIPAA requirements, confidentiality standards, and Privia security protocols.
  • Demonstrate professionalism, accountability, and patient-centered service in all interactions.
Requirements
  • Strong verbal and written communication skills.
  • Analytical problem-solving abilities and high attention to detail.
  • Solid understanding of healthcare billing and insurance concepts.
  • Ability to clearly explain complex billing information in patient-friendly language.
  • Comfort working across multiple systems and tools simultaneously.
  • Organized, self-motivated, and collaborative approach to work.
Pay and Benefits

Starting pay - $14/hr plus shift differential(extra $1/hr nights & wkds)

Working hours between - 9:00am-6:00pm (EST) ; Work Days - M-F 

Paid Training - typically 2 weeks in length from 9:00am-6:00pm Mon-Fri (EST)

Status - Full Time 40 hours, Benefit eligible 1st of month after 60 days 

The above statements are intended to describe the general nature and level of work and are not intended to be an exhaustive list of all responsibilities, duties, and skills required of the job

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.