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Remote Medical Claims Processor Jobs in Sun Prairie, WI

Auxiant

Claims Examiner

Madison, WI · On-site +1

Responsible for processing medical claims and correspondence and handling customer service calls from members, providers, and clients. Essential Functions: * Process claims in a timely manner with ...

Rural Mutual Insurance

Desk Auto Claims Adjuster

Madison, WI · On-site +1

$49K - $65K/yr

You'll enjoy the flexibility of remote work while serving customers across Wisconsin. Candidates ... processes, and valuation methods. • Experience evaluating liability and handling minor bodily ...

WPS

Medicare Pricing Analyst

Madison, WI · On-site +1

... Medicare claims processing and coding guidelines. This role supports the implementation and ... We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois ...

WPS

Pharmacy Vendor Coordinator

Madison, WI · On-site +1

$19 - $24.75/hr

Understanding of pharmacy claims processing, formulary management, and basic utilization review ... Remote and hybrid work options available * Performance bonus and/or merit increase opportunities ...

WPS Health Solutions

Pharmacy Vendor Coordinator

Madison, WI · On-site +1

$19 - $24.75/hr

Understanding of pharmacy claims processing, formulary management, and basic utilization review ... Remote and hybrid work options available * Performance bonus and/or merit increase opportunities ...

New

AprilAire

Sales Data Analyst-LTE

Madison, WI · Remote

... claims processing function. This temporary part-time opportunity is designed to help manage ... Remote--candidate must live within a 75 mile radius of Madison, WI Responsibilities The primary ...

AprilAire

Sales Data Analyst-LTE

Madison, WI · Remote

... claims processing function. This temporary part-time opportunity is designed to help manage ... Remote--candidate must live within a 75 mile radius of Madison, WI Responsibilities The primary ...

West Bend Insurance Company

Property Adjuster

Madison, WI · On-site +1

$68K - $86K/yr

Job Summary Handle complex property claims in the Madison, WI area with minimal supervision and ... Work Location This is a fully remote/work from home role where you will spend up to 50% of your ...

micro1 AI

Medical Writing Manager

Madison, WI · Remote

$50 - $80/hr

Remote micro1 is engaging Medical Writers / Clinical Document Authors to participate in a customer ... Trace narrative claims to source records--tables, figures, listings, and protocols--to verify that ...

micro1 AI

Medical Billing Specialist

Madison, WI · Remote

$50 - $80/hr

Remote micro1 is engaging Medical Writers / Clinical Document Authors to participate in a customer ... Trace narrative claims to source records--tables, figures, listings, and protocols--to verify that ...

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All JobsMedical Claims Processor JobsRemote Medical Claims Processor JobsRemote Medical Claims Processor Jobs in Sun Prairie, WI

Remote Medical Claims Processor information

See Sun Prairie, WI salary details

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$25

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

As of Sep 7, 2026, the average hourly pay for remote medical claims processor in Sun Prairie, WI 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.

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The most popular types of Medical Claims Processor jobs in Sun Prairie, WI are:

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For Remote Medical Claims Processor jobs in Sun Prairie, WI, the most frequently searched job titles are:

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Remote Medical Claims Processor jobs near you

Claims Examiner

Auxiant

Madison, WI • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

Job description

Job Type
Full-time
Description
https://www.auxiant.com/
Auxiant's Mission Statement and Core Values
Mission:
An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results.
Core Values: Independent Solutions. REAL Results
Respect
Empowerment
Agility
Leadership
Be part of a growing and prospering company as a Claims Examiner. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package.
Job Summary: Responsible for processing medical claims and correspondence and handling customer service calls from members, providers, and clients.
Essential Functions:
  • Process claims in a timely manner with acceptable accuracy
  • Answer inbound phone calls from members and providers.
  • Handle correspondence from members and providers in a timely manner.
  • Analyze self-funded health plans and use plan language to correspond to necessary inquiries, both verbally and written.
  • Interpret plan design and language to analyze claim edits.
  • Point of contact for clients and members.
  • Work Customer Service Tickets.

Nonessential Functions:
  • Other duties as assigned or appropriate

Education/Qualifications:
  • Familiarity with ICD-10 and CPT coding
  • Understanding of medical claims processing guidelines
  • Proficient PC skills including email, record keeping, routine database activity, word processing, spreadsheet and 10-key
  • QicLink experience
  • Medical Terminology
  • High school diploma and 1-2 years related experience; or equivalent combination of education and experience

*Full benefits including: Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more
Job Type: Full-time
Schedule:
  • 8 hour shift
  • Day shift
  • Monday to Friday

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