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Remote Medical Claims Processor Jobs in Spring Hill, TN

CCMSI

Multi-Line Claims Consultant

Nashville, TN · Remote

$75K - $85K/yr

Remote Schedule: Monday - Friday Salary Range: $75,000 - $85,000 annually Build Your Career With ... We don't just process claims-we support people. As the largest privately-owned Third Party ...

Qualifacts

RCMS Configuration Associate

Nashville, TN · On-site +1

Remote candidates will not be considered. RCMS Configuration Associate Summary of the RCMS ... payer setup, claims processes, and customer-facing implementation support. The Configuration ...

Surgery Partners

Biller - Remote

Brentwood, TN · Remote

$17.75 - $22.75/hr

ESSENTIAL FUNCTIONS: • Resolves disputed claims by gathering, verifying, providing additional ... medical staff and external agencies. • Ability to identify, analyze, and solve claim issues. • ...

Deloitte

Epic Denials Manager

Nashville, TN · 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 ...

EnableComp

DRG Auditor (REMOTE)

Franklin, TN · Remote

$28 - $31.75/hr

Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert ... Navigate medical records efficiently, targeting specific sections (e.g., discharge summary ...

Enablecomp

DRG Auditor (REMOTE)

Franklin, TN · Remote

$27 - $30.50/hr

Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert ... Navigate medical records efficiently, targeting specific sections (e.g., discharge summary ...

EnableComp

DRG Auditor (REMOTE)

Franklin, TN · Remote

$27 - $30.50/hr

Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert ... Navigate medical records efficiently, targeting specific sections (e.g., discharge summary ...

Enablecomp

DRG Auditor (REMOTE)

Franklin, TN · Remote

$27 - $30.50/hr

Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert ... Navigate medical records efficiently, targeting specific sections (e.g., discharge summary ...

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All JobsMedical Claims Processor JobsRemote Medical Claims Processor JobsRemote Medical Claims Processor Jobs in Spring Hill, TN

Remote Medical Claims Processor information

See Spring Hill, TN salary details

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

As of Sep 8, 2026, the average hourly pay for remote medical claims processor in Spring Hill, TN is $18.31, according to ZipRecruiter salary data. Most workers in this role earn between $16.25 and $20.34 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 job categories do people searching Remote Medical Claims Processor jobs in Spring Hill, TN look for?

The top searched job categories for Remote Medical Claims Processor jobs in Spring Hill, TN are:

What cities near Spring Hill, TN are hiring for Remote Medical Claims Processor jobs?

Cities near Spring Hill, TN 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 Spring Hill, TN as of September 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, and 6% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $38,075 per year, or $18.3 per hour.

Appeals Specialist - (CGS Admin)

Nashville, TN • On-site, Remote

Ourhrconnect
See more jobs at Ourhrconnectexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 21 days ago

Job description


Summary
 Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
This open position is within one of our subsidiary companies called CGS Administrators. CGS has been a proven provider of administrative and business services for state Medicaid agencies, managed care organizations, commercial health plans, Medicaid members, Medicare beneficiaries, healthcare providers, and medical equipment suppliers for more than 50 years.
Description
 

Logistics: CGS (cgsadmin.com) - one of BlueCross BlueShield's South Carolina subsidiary companies.

Location: This position is onsite with work hours starting between 6:00 AM and 7:30 AM Central Time. You will work an 8-hour shift schedule. It may be necessary, given the business need to work occasional overtime. This role is fully remote or can sit onsite at 26 Century Blvd, Suite ST610 Nashville, TN 37214 United States of America.

  • SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). As a Service Contract Act (SCA) employee, you are required to enroll in our health insurance, even if you already have other health insurance. Until your enrollment is complete, you will receive supplemental pay for health coverage. Your coverage begins on the first day of the month following 28 days of full-time employment.

What You'll Do:

  • Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy.

  • Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools.

  • Updates letter's and documents within the department when necessary.

  • May gather and prepare documentation for legal inquiries and administrative requests.

To Qualify For This Position, You'll Need The Following:

  • Required Education: High School Diploma or equivalent

  • Required Work Experience: 2 years job related field.

  • Required Skills and Abilities: Demonstrated proficiency in word processing and spreadsheet software. Excellent organizational, customer service, and written and verbal communication skills. Good judgment skills. Proficiency in spelling, punctuation, and grammar skills.

  • Required Software and Tools: Microsoft Office.

We Prefer That You Have the Following:

  • Experience in medical claims processing, appeals, or coding strongly preferred

  • Medicare Part B experience preferred

  • Strong computer proficiency, with the ability to navigate multiple systems and work across dual screens efficiently

  • Intermediate-level Excel skills

  • Experience creating letters and documents by reviewing appeals and extracting information with a high degree of accuracy; updates departmental documents as needed.

Our Comprehensive Benefits Package Includes The Following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

  • Subsidized health plans, dental and vision coverage

  • 401k retirement savings plan with company match

  • Life Insurance

  • Paid Time Off (PTO)

  • On-site cafeterias and fitness centers in major locations

  • Education Assistance

  • Service Recognition

  • National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What To Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.

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