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Remote Medical Claims Processor Jobs in Dover, NJ

CoAction

Claims Intern

Morristown, NJ · On-site +1

$15.50 - $20.50/hr

Gain a thorough understanding of the claims process through an apprenticeship with a senior claim ... Coaction's internship program does NOT offer remote work. Our internship roles are 5 days a week in ...

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Remote Medical Claims Processor information

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

As of Aug 29, 2026, the average hourly pay for remote medical claims processor in Dover, NJ is $19.95, according to ZipRecruiter salary data. Most workers in this role earn between $17.74 and $22.16 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 Dover, NJ are hiring for Remote Medical Claims Processor jobs?

Cities near Dover, NJ 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 Dover, NJ as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 19% Part Time, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $41,487 per year, or $19.9 per hour.

Experienced Remote Medical Biller DME Fast Paced

HEARTS ENTERAL LLC

Mountain View, NJ • Remote

$18 - $26/hr

Full-time

Medical

Re-posted 24 days ago

Job description

Job Overview: REMOTE 1099 CONTRACTOR POSITION ONLY (NO W-2) ***FAST PACED environment ***A skilled and detail-oriented Medical Billing & Claims Specialist. In this role, you will be responsible for processing and submitting accurate medical claims to insurance companies, ensuring that all claims are compliant with payer requirements, and addressing any issues that may arise in the claims process. Contractors will have strong knowledge of medical billing procedures, insurance guidelines, and the ability to work effectively in a fast-paced environment.

Key Responsibilities:

Claims Submission:

    • Review patient records and clinical documentation to ensure accurate coding and billing of services rendered.
    • Prepare and submit medical claims to insurance companies (including Medicare, Medicaid, and private insurers) using the appropriate billing formats and codes.
    • Ensure that claims are submitted in a timely manner to avoid delays in payment.
    • Closely following Hearts Enteral’ s medical foods system and time frames.

·

Claims Follow-Up & Resolution:

    • Track the status of submitted claims and follow up with insurance companies based on Hearts Enteral’ s timeframe to resolve any issues or denials in a timely manner.
    • Making sure the claims Master Report is completed in full and on time for Hearts Enteral’ s weekly meeting.
    • Investigate and resolve claim denials, rejections, and underpayments by communicating with insurance providers and patients.
    • Work with the patient intake department to collaborate that claims are processed correctly, and payments are received.
    • Appeal denied claims, providing necessary documentation and corrections as required, based on Hearts Enteral’ s timeframe.

Coding and Compliance:

    • Ensure accurate coding of medical foods and medical supplies, diagnoses, and services according to ICD-10, and HCPCS coding systems.
    • Stay up-to-date with payer policies, industry standards, and regulatory changes to ensure compliance with billing and coding requirements.

o Verify that all necessary documentation (ex. authorization numbers) is included with claims to support coding accuracy and prevent delays in payment.

· Patient Account Management:

o Review Master Report to ensure that all charges are correct, dates of services, and all products are properly accounted for.

o Communicate with patients to resolve billing inquiries, including health plan payments sent to members immediately.

Documentation and Reporting:

    • Maintain accurate and organized records of all claims, payments, denials, and correspondence with insurance providers in Hearts Enteral EMR Office Ally patient charts.
    • Prepare and submit regular weekly reports on claim status, outstanding claims, and revenue cycle performance.
    • Document all interactions with insurance companies, patients, and internal departments.

Collaboration & Team Support:

    • Collaborate with the intake team, and other departments to ensure the accuracy and completeness of claims.
    • Work closely with the intake team, specialists and departments to identify and resolve any issues affecting the revenue cycle.
    • Provide training and support to other team members as needed.
    • Insurance Payer Enrollment:
    • Ensure providers are enrolled with necessary insurance payers and networks
    • Research and identify all insurance companies and networks a provider should be enrolled with. The goal is to be enrolled with all insurance companies including Medicare and Medicaid.
    • Submit credentialing applications to payers, ensuring all required documents are included.
    • Track payer responses, following up on pending applications to ensure timely approvals.
    • Maintain Hearts Enteral’ s insurance payer credentialing tracker for each provider.

Other duties:

  • Assist with any other projects directed by management

Company Description

Hearts Enteral DME is the sister company of our non-profit organization Compassion Works Medical. Our mission is to help fight the challenges of healthcare reimbursement for people who struggle with rare diseases and conditions that require enteral nutrition and medical foods to sustain and prolong their lives. Web. www,heartsenteral.com. www.compassionworksmrs.com.