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Remote Medical Claims Processor Jobs in Hamilton, OH

Deloitte

Epic Denials Manager

Cincinnati, OH · 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 ...

Deloitte

Epic Denials Management Operator

Cincinnati, OH · 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 ...

System One

Business Analyst

Fairfield, OH · 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 ...

System One

Business Analyst

Fairfield, OH · 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 ...

System One

Business Analyst

Fairfield, OH · 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 ...

Medpace, Inc.

Medical Director

Cincinnati, OH · 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 ...

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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 30, 2026, the average hourly pay for remote medical claims processor in Hamilton, OH is $18.13, according to ZipRecruiter salary data. Most workers in this role earn between $16.11 and $20.14 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 are the most commonly searched types of Medical Claims Processor jobs in Hamilton, OH?

The most popular types of Medical Claims Processor jobs in Hamilton, OH are:

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For Remote Medical Claims Processor jobs in Hamilton, OH, the most frequently searched job titles are:

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The top searched job categories for Remote Medical Claims Processor jobs in Hamilton, OH are:

What cities near Hamilton, OH are hiring for Remote Medical Claims Processor jobs?

Cities near Hamilton, OH 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 Hamilton, OH as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, and 6% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $37,717 per year, or $18.1 per hour.

Claims Specialist with FineOS - Remote

Cincinnati, OH • Remote

Northern Base
See more jobs at Northern Baseexternal

Full-time

PTO

Re-posted 23 days ago

Job description

Claims Specialist with FineOS
Remote
Fulltime

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.