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Remote Medical Claims Processor Jobs in Randallstown, MD

J29 Inc.

Nurse SME - Contingent

Millersville, MD · On-site +1

$100K - $120K/yr

Remote About J29 J29 is an employee centered healthcare management consulting company that specializes in processing, reviewing, and analyzing medical claims, records, disputes, and audits.

J29 Inc.

HR Generalist

Millersville, MD · On-site +1

$40K - $50K/yr

Remote, with preference given to candidates in eastern standard time zone Report To: Director of ... processing, reviewing, and analyzing medical claims, records, disputes, and audits. Established 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 Sep 5, 2026, the average hourly pay for remote medical claims processor in Randallstown, MD is $18.82, according to ZipRecruiter salary data. Most workers in this role earn between $16.73 and $20.91 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.

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Remote Medical Claims Processor jobs near you

Payment and Medical Policy Coordinator (Remote)

CareFirst

Baltimore, MD • Remote

Full-time

Retirement

Re-posted 14 days ago

CareFirst BlueCross BlueShield rating

7.3

Company rating: 7.3 out of 10

Based on 31 frontline employees who took The Breakroom Quiz

241st of 315 rated insurance

Job description

Resp & Qualifications

PURPOSE: 
The Policy Coordinator will support the end-to-end implementation of medical and payment policies by coordinating cross-functional activities required to operationalize policy decisions. This role ensures business readiness across impacted functions, including claims, configuration, provider communications and operations, and provides support during testing, implementation, and post-implementation validation. We are looking for an experienced professional to work remotely from within the greater Baltimore/Washington metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities.
ESSENTIAL FUNCTIONS:

  • Coordinates cross-functional activities required to implement medical and payment policy changes, including alignment across claims, configuration, provider operations, network management, and compliance teams. Tracks key milestones and ensures readiness for policy go-live.
  • Supports business readiness activities, including impact assessments, readiness checklists, and coordination of implementation plans. Works with stakeholders to identify operational, staffing, and workflow impacts associated with policy changes.
  • Coordinates testing activities related to policy implementation, including user acceptance testing (UAT), validation of claims adjudication logic, and issue tracking/resolution. Ensures testing results are documented and communicated to stakeholders.
  • Maintains implementation documentation, including timelines, status reports, risks, and dependencies. Provides regular updates to leadership and ensures transparency across teams.
  • Supports post-implementation monitoring by coordinating issue tracking, identifying gaps in execution, and escalating risks or defects to appropriate stakeholders for resolution.

QUALIFICATIONS:
Education Level: Bachelor's Degree in Health Administration, Business, Finance or related discipline OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Licenses/Certifications Preferred:

  • Certified Coder (CCS or CPC)-AHIMA or AAPC AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS). 

Experience:  Experience in health plan operations, project coordination, policy implementation, claims operations, or related functions.
Preferred Qualifications:

  • Experience working in a health plan environment (Medical Policy, Payment Policy, Claims, or Operations).
  • Experience coordinating cross-functional projects or implementations.
  • Familiarity with claims systems, configuration processes, or policy governance. 

Knowledge, Skills and Abilities (KSAs)

  • Strong organizational and coordination skills across multiple teams and stakeholders.
  • Ability to manage multiple workstreams and meet deadlines. 
  • Strong communication skills with ability to translate policy decisions into operational tasks
  • Working knowledge of managed care, claims processes, and policy implementation workflows. 
  • Ability to identify risks, track issues, and escalate appropriately. 
  • Use of Microsoft Office applications (Excel, PowerPoint, Word) and project tracking tools. 
  • Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.


Salary Range: 51,264 - 101,816

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

#LI-SS1 

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