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Remote Medical Claims Processor Jobs in Remote, OR

Primus Software Corporation

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Claims QA/BA (Healthcare- Contract to hire)

OR · Remote

$45 - $68/hr

Remote Description: Responsible for claims testing for health care projects. Drive the test strategy and process, domain knowledge, perform analysis of business requirements, designs and develops ...

Team8

Bluespine-Sr. FWA Analyst

OR · On-site +1

... medical coding, DRG methodologies, CPT/HCPCS coding guidelines, physician specialty guidelines, reimbursement programs, claims adjudication processes, member contract benefits, regulatory agency ...

Bekaert

Application Engineer Crane&Industrial

OR · Remote

You bring application expertise directly to the field, resolving quality claims, conducting ... Strong understanding of T&I processes, machinery operation, and production technologies. * Problem ...

Sapiens

Sales Executive, L&A

OR · On-site +1

Remote This Sales Executive is responsible for generating new insurance software sales and services ... Utilize sales methodologies, processes, and best practices to increase the probability of success;

Sapiens

Pre-Sales Engineer, Workers' Comp

OR · On-site +1

Remote (US) Sapiens is on the lookout for a Pre-Sales Engineer, WC to become a key player in our ... Leading the benefits assessment process and developing customized ROI/ROR analysis * Architecting ...

Project Sapiens

Sales Executive, L&A

OR · Remote

Remote This Sales Executive is responsible for generating new insurance software sales and services ... Utilize sales methodologies, processes, and best practices to increase the probability of success;

Sapiens

Vice President of Sales, North America Life

OR · On-site +1

Remote The Vice President of Sales, North America (Life) will report directly to the Chief Revenue ... processes, tools, and talent required to exceed them. * Lead, mentor, and develop senior sales and ...

Sapiens

Renewal Operations Manager

OR · On-site +1

Remote - North America Position Summary: Sapiens is building a dedicated renewal function - and you ... You will own a defined segment of the NA renewal book, managing the commercial renewal process end ...

Sapiens

Senior Project Manager

OR · On-site +1

Remote Sapiens is on the lookout for a Sr. Project Manager (SNAP) to become a key player in our ... Each country has a local flavor, but here's what you can expect during our recruitment process:

Sapiens

Sales Development Representative

OR · On-site +1

Remote Insurance is changing fast. The conversations that start pipeline happen earlier, smarter ... Each country has a local flavor, but here's what you can expect during our recruitment process:

Sapiens

Senior Business Analyst

OR · On-site +1

$86K - $112K/yr

US - Remote Position Summary The role of the Senior Business Analyst is to provide an IT interface ... Provide guidance relative to underwriting (manual and underwriting) measures and processes ...

Sapiens

Associate Business Analyst

OR · On-site +1

US - Remote Sapiens is on the lookout for an Associate Business Analyst to become a key player in ... processes, standards, and best practices. • Building foundational skills in business modeling ...

AM Pierce and Associates

Subcontracts Manager

OR · On-site +1

$115K - $165K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote (US Only) The Description: The Subcontracts Manager is responsible for the management ... Administer subcontract modifications, amendments, claims, disputes, and other subcontract actions ...

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Remote Medical Claims Processor information

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$19

$25

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

As of Aug 17, 2026, the average hourly pay for remote medical claims processor in Remote, OR is $19.45, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $21.63 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

Claims QA/BA (Healthcare- Contract to hire)

Primus Software Corporation

OR • Remote

$45 - $68/hr

Full-time

Posted 5 days ago

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Job description

Job description

Job Title: Healthcare Claims EDI BA/QA

Duration: 06 Months (Contract to Hire) – W2 Only

Location: Remote


Description:

Responsible for claims testing for health care projects. Drive the test strategy and process, domain knowledge, perform analysis of business requirements, designs and develops test plans, ensures quality process, coordinates with customers on delivery and deployments. Works in team environment and provides testing guidance throughout the entire life cycle. Responsible to meet customer expectations, troubleshoot problems in the application and assisting customers in implementation decisions.

1.            Candidate should have strong health care domain experience and should have good knowledge of Medicaid and Medicare.

2.            Candidate should have hands-on experience on claims processing and Adjudication processes.

3.            Must have good experience in Reference code/data sets required in Claims adjudication.

4.            Must have prior experience or understanding in configuring benefits or programs in claims system across various sub-systems.

5.            Should be able to run queries and perform basic system analysis, RCA etc.,

6.            Should work closely with the client and development team during the stages of development, and conduct demos at completion of milestone, track and close feedback from such demos

7.            Must have excellent written and spoken communication skills. Should be able to multitask between internal team and clients based on priority tasks

8.            Work Closely with Dev, architecture and Design teams to define the GUI view and platform requirements, which is the foundation of the product.

9.            In depth understanding of Claims and Claims lifecycle     

10.         Claim Types

11.         Claim Formats:

-              EDI X12 formats like 837P/I/D

-              X12 formats 835, 834, 270/271, 276/277

12.         Claim System:

-              Familiarity with systems like CMdS, GHS, Facets and etc

Testing knowledge and E2E Testing

Company Description

Primus Software Corporation. Primus Software Corporation is a global staff augmentation firm providing a wide-range of talent on-demand and total workforce solutions. We have excellent domain expertise in all verticals. We provide long term solutions with quality as our main focus. To learn more about Primus Software Corporation, please visit our website www.primussoftcom. I recently came across your resume on job boards, and I wanted to reach out to you regarding an exciting job opportunity that I believe aligns perfectly with your skills and experience.