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Remote Medical Claims Processor Jobs in Pawtucket, RI

Bcbsri

Senior Medical Economics Analyst

Providence, RI · On-site +1

$93K - $140K/yr

... process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds ... It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid ...

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Remote Medical Claims Processor information

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$13

$18

$25

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

As of Sep 3, 2026, the average hourly pay for remote medical claims processor in Pawtucket, RI is $18.94, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $21.06 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

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

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Remote Medical Claims Processor jobs near you
Infographic showing various Remote Medical Claims Processor job openings in Pawtucket, RI as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 6% Part Time, and 9% Contract. Highlights an 1% Hybrid, and 99% Remote job distribution, with an average salary of $39,403 per year, or $18.9 per hour.

Senior Medical Economics Analyst

Bcbsri

Providence, RI • On-site, Remote

$93K - $140K/yr

Full-time

Medical, Dental, Vision, PTO

Re-posted 17 days ago

Job description

Pay Range:

$93,600.00 - $140,400.00 

Please emailHR_Talent_AcquisitionTeam@bcbsri.orgif you are a candidate seeking a reasonable accommodation for the application and/or interview process.

At BCBSRI, our greatest resource is our people.

We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well.


We recognize that to do your best work, you have to be your best self.
It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.


Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued.

Join others who value a workplace for all.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.

We're dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.

 

Why this job matters:

We are a growing regional health plan dedicated to making healthcare more accessible and affordable for the communities we serve. As a lean, high-impact team, we rely on data-driven insights to manage costs, evaluate clinical programs, and shape the Total Cost of Care (TCOC) and the organizational strategy.

We are seeking a motivated Senior Medical Economics Analyst to play a pivotal role in solving the healthcare affordability crisis. Operating with limited oversight, you will dive deep into medical claims and healthcare data to uncover cost drivers and translate complex data into actionable strategies. As a key partner to business leaders, you will play an important role in the design, value, and monitoring of cost-saving initiatives from conception through post-implementation value realization.

If you are a self-starter with a passion for analytics, strong technical skills, and the drive to make a tangible difference in healthcare affordability, we want you on our team.

What you will do:

  • Cost Driver Analysis: Analyze medical claims and related healthcare data to identify trends, cost drivers, and opportunities for medical cost savings.
  • Initiative Valuation & Monitoring: Partner with cross-functional leaders to scope new initiatives, calculate the potential financial impact, and monitor outcomes post-implementation for value realization.
  • Leadership Reporting: Synthesize complex analytics into clear, actionable insights and present findings directly to business leaders to drive strategic decisions.
  • Tool Innovation: Continuously explore and adopt new tools and technologies to elevate our insight generation and predictive capabilities.

What you need to succeed:

  • Education: Bachelor's or Master's degree in a quantitative field (e.g., Mathematics, Statistics, Economics, Data Science, or Health Informatics).
  • Experience: Minimum 5+ years of experience analyzing healthcare data-preferably within a health plan or payer setting-and presenting actionable insights to leadership.
  • Industry Knowledge: Deep understanding of healthcare claims, member enrollment, provider data, and standard healthcare metrics (e.g., PMPM, utilization rates, risk adjustment).
  • Autonomy: Proven ability to operate as a self-starter with limited oversight, managing multiple projects in a fast-paced environment.
  • SQL: Advanced SQL expertise for complex data extraction, manipulation, and ETL processes.
  • Programming: Proficiency in Python for data analysis, modeling, and automation.
  • Visualization: Strong experience building interactive dashboards and visualizations using Power BI or Snowflake's native capabilities.
  • Data Platforms: Experience working within a Snowflake environment is highly preferred; familiarity with modern data stack tools is a plus.
 

Location:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:

  • In-office: onsite 5 days per week
  • Hybrid: onsite 2-4 days per week
  • Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia

Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer.

The law requires an employer to post notices describing the Federal laws. Please visitwww.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.

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