To provide Absence case management and claim adjudications, based on medical documentation and the ... Reviews client critical deliverables, manages the overall workload, and second-level process ...
Quick apply
To provide Absence case management and claim adjudications, based on medical documentation and the ... Reviews client critical deliverables, manages the overall workload, and second-level process ...
Quick apply
To provide Absence case management and claim adjudications, based on medical documentation and the ... Reviews client critical deliverables, manages the overall workload, and second-level process ...
... in remote locations across the country. * Responsible for performance, development and coaching of ... Provides vision, goals, and direction for claims process and outcome improvement initiatives ...
... in remote locations across the country. * Responsible for performance, development and coaching of ... Provides vision, goals, and direction for claims process and outcome improvement initiatives ...
... remote candidates. Job title and salary will be dependent upon successful applicant's level of ... Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental ...
... remote candidates. Job title and salary will be dependent upon successful applicant's level of ... Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental ...
Cincinnati, OH ยท Remote
Process Bodily Injury, and coverage claims in accordance with established office procedures.Work ... Knowledge of legal and medical terminology.Excellent negotiation, communication, written ...
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Cincinnati, OH ยท Remote
Process Bodily Injury, and coverage claims in accordance with established office procedures.Work ... Knowledge of legal and medical terminology.Excellent negotiation, communication, written ...
Cincinnati, OH ยท On-site +1
Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental ... process. Learn more at *Excludes seasonal employees and interns.
Cincinnati, OH ยท On-site +1
Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental ... process. Learn more at *Excludes seasonal employees and interns.
Cincinnati, OH ยท 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 ...
Cincinnati, OH ยท 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 ...
... 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 ...
... 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 ...
Cincinnati, OH ยท 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 ...
Cincinnati, OH ยท 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 ...
Cincinnati, OH ยท 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 ...
Cincinnati, OH ยท 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 ...
Cincinnati, OH ยท 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 ...
Cincinnati, OH ยท 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 ...
Cincinnati, OH ยท Remote
$70 - $90/hr
Remote micro1 is engaging Microbiologists to contribute their scientific expertise to a unique ... Document experimental findings and processes with a focus on clarity for AI training data.
Cincinnati, OH ยท Remote
$70 - $90/hr
Remote micro1 is engaging Microbiologists to contribute their scientific expertise to a unique ... Document experimental findings and processes with a focus on clarity for AI training data.
Fairfield, OH ยท Remote
$55/hr
Remote - offsite Hours: 40.0 Security Clearance: Overview W2 ONLY CONTRACT NO C2C, NO sponsorship ... Experience within Property & Casualty (P&C) insurance, including underwriting, claims, and policy ...
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Fairfield, OH ยท Remote
$55/hr
Remote - offsite Hours: 40.0 Security Clearance: Overview W2 ONLY CONTRACT NO C2C, NO sponsorship ... Experience within Property & Casualty (P&C) insurance, including underwriting, claims, and policy ...
Fairfield, OH ยท Remote
$55/hr
Remote - offsite Hours: 40.0 Security Clearance: Overview W2 ONLY CONTRACT NO C2C, NO sponsorship ... Experience within Property & Casualty (P&C) insurance, including underwriting, claims, and policy ...
Quick apply
Fairfield, OH ยท Remote
$55/hr
Remote - offsite Hours: 40.0 Security Clearance: Overview W2 ONLY CONTRACT NO C2C, NO sponsorship ... Experience within Property & Casualty (P&C) insurance, including underwriting, claims, and policy ...
Fairfield, OH ยท Remote
$55/hr
Remote - offsite Hours: 40.0 Security Clearance: Overview W2 ONLY CONTRACT NO C2C, NO sponsorship ... Experience within Property & Casualty (P&C) insurance, including underwriting, claims, and policy ...
Quick apply
Fairfield, OH ยท Remote
$55/hr
Remote - offsite Hours: 40.0 Security Clearance: Overview W2 ONLY CONTRACT NO C2C, NO sponsorship ... Experience within Property & Casualty (P&C) insurance, including underwriting, claims, and policy ...
Cincinnati, OH ยท Remote
$120K - $216K/yr
Defend and litigate lawsuits involving a broad range of employment-related claims and agency ... Medical, dental, vision, life and disability insurance * 401(k) Retirement Plan * Flexible Spending ...
Cincinnati, OH ยท Remote
$120K - $216K/yr
Defend and litigate lawsuits involving a broad range of employment-related claims and agency ... Medical, dental, vision, life and disability insurance * 401(k) Retirement Plan * Flexible Spending ...
Fairfield, OH ยท On-site +1
$175K - $225K/yr
The position is fully remote. Salary : The pay range for this position is $175,000 - $225,000 ... claims processes * experience reviewing, drafting, negotiating, and interpreting reinsurance ...
Fairfield, OH ยท On-site +1
$175K - $225K/yr
The position is fully remote. Salary : The pay range for this position is $175,000 - $225,000 ... claims processes * experience reviewing, drafting, negotiating, and interpreting reinsurance ...
Cincinnati, OH ยท Remote
$120K - $216K/yr
Assessment of the claims and providing an analysis to the client and carrier. * Direct client and ... Medical, dental, vision, life and disability insurance * 401(k) Retirement Plan * Flexible Spending ...
Cincinnati, OH ยท Remote
$120K - $216K/yr
Assessment of the claims and providing an analysis to the client and carrier. * Direct client and ... Medical, dental, vision, life and disability insurance * 401(k) Retirement Plan * Flexible Spending ...
Cincinnati, OH ยท On-site +1
... process. Your focus will be on identifying client needs, presenting tailored solutions, and closing ... Comprehensive benefits including medical, dental, vision, 401k, and paid time off * 100% remote ...
Cincinnati, OH ยท On-site +1
... process. Your focus will be on identifying client needs, presenting tailored solutions, and closing ... Comprehensive benefits including medical, dental, vision, 401k, and paid time off * 100% remote ...
Cincinnati, OH ยท On-site +1
... days in office; remote considered in exceptional circumstances) Essential Functions * Lead a ... process changes, or product improvements. * Partner with Claims leadership to identify and deliver ...
Cincinnati, OH ยท On-site +1
... days in office; remote considered in exceptional circumstances) Essential Functions * Lead a ... process changes, or product improvements. * Partner with Claims leadership to identify and deliver ...
Cincinnati, OH ยท On-site +1
This role also has the ability to be fully remote with the right experience**. Responsibilities ... processes, educational efforts, management of medical information, and reviewing and editing of ...
Cincinnati, OH ยท On-site +1
This role also has the ability to be fully remote with the right experience**. Responsibilities ... processes, educational efforts, management of medical information, and reviewing and editing of ...
$12.99 - $13.98
6% of jobs
$13.98 - $14.98
6% of jobs
$14.98 - $15.98
11% of jobs
$16.09 is the 25th percentile. Wages below this are outliers.
$15.98 - $16.98
15% of jobs
The median wage is $17.71 / hr.
$16.98 - $17.97
16% of jobs
$17.97 - $18.97
11% of jobs
$19.92 is the 75th percentile. Wages above this are outliers.
$18.97 - $19.97
11% of jobs
$19.97 - $20.97
11% of jobs
$20.97 - $21.96
6% of jobs
$21.96 - $22.96
5% of jobs
$22.96 - $23.96
2% of jobs
$12
$18
$23
| Aspect | Remote Medical Claims Processor | Remote Medical Billing Specialist |
|---|---|---|
| Credentials | Typically requires medical coding or claims processing certifications | Often requires medical billing certifications and coding knowledge |
| Work Environment | Remote, healthcare or insurance companies | Remote, healthcare providers or billing companies |
| Industry Usage | Insurance companies, third-party administrators | Hospitals, clinics, billing service providers |
| Job Focus | Processing and reviewing insurance claims for reimbursement | Preparing 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.
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.

Full-time
PTO
Re-posted 3 days ago
Responsibilities:
To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments.
Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or continuous)
Review and analyze medical information (i.e. attending physician reports, medical records such as diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined.
Approval or denial on FMLA claims as per Insurance carrier, and employer’s guidelines
Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to US paid family law regulations.
Review claims for Not in good order cases, and work on securing missing documentations including employee, physician, or employer outreach.
Communicates clearly with the claimants and clients to set expectations on all aspects of claims process either by phone and/or written correspondence.
Reviews client critical deliverables, manages the overall workload, and second-level process escalation.
Determines benefits due, makes timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets.
Refers cases as appropriate to team lead and clinical case management
Responsible for managing the day-to-day workload and first-level process escalation, and reviews processes for accuracy and timeliness where applicable in case of peer reviews.
Provide ideas to management on continuous improvement and service level management
Performs other duties or participates in special projects as assigned
Requirements:
1+ year of Disability/FMLA/PFL claims or insurance claims experience
Experience working with FINEOS
Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports
Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices mandatory
Excellent oral and written communication, including presentation skills
Strong Analytical, decision making, problem solving, and people management skills
Computer experience with keyboarding skills and proficiency in using software applications and packages including MS Office (Excel, Word, PPT)
Willingness to embrace change in a fast paced work environment
A strong desire to continuously learn and improve
Identify escalated cases and work with Team Leader to develop a plan to address key issues.