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Remote Medical Claims Processor Jobs in Sun Prairie, WI

Corvel

Indemnity Claims Specialist

Madison, WI · Remote

$51K - $83K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms ... Manages non-complex and non-problematic medical only claims and minor lost-time workers ...

Capstone Search Group

Be Seen First

Senior Claims Adjuster, Workers Compensation - Remote (10228)

Madison, WI · Remote

$65K - $95K/yr

As Senior Claims Adjuster, Workers Compensation you are responsible for managing the process from ... Fully remote but requires experience with workers compensation claims in the following states ...

WPS Health Solutions

Medical Director

Madison, WI · On-site +1

As a secondary consideration, we do offer remote work in the following approved states: Colorado ... We process claims and provide customer support for beneficiaries of the Medicare program and manage ...

WPS

Medical Director

Madison, WI · On-site +1

As a secondary consideration, we do offer remote work in the following approved states: Colorado ... We process claims and provide customer support for beneficiaries of the Medicare program and manage ...

WPS

Medical Review Nurse Analyst

Madison, WI · On-site +1

$68K - $70K/yr

We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois ... We process claims and provide customer support for beneficiaries of the Medicare program and manage ...

State of Wisconsin

IT Supervisor

Madison, WI · On-site +1

$104K - $119K/yr

... medical determinations for SSA disability claims. The DDB also processes a small number of State ... Remote work flexibility will be discussed in more detail during the interview process. DHS does not ...

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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

$13

$18

$25

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

As of Jul 26, 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 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.

What Is the Job of 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 are the key skills and qualifications needed to thrive as a Remote Medical Claims Processor, and why are they important?

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 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.
More about Remote Medical Claims Processor jobs
What are popular job titles related to Remote Medical Claims Processor jobs in Sun Prairie, WI? For Remote Medical Claims Processor jobs in Sun Prairie, WI, the most frequently searched job titles are:
What cities near Sun Prairie, WI are hiring for Remote Medical Claims Processor jobs? Cities near Sun Prairie, WI with the most Remote Medical Claims Processor job openings:
Remote Medical Claims Processor jobs near you

Indemnity Claims Specialist

CorVel Enterprise Claims, Inc.

Madison, WI • Remote

$51K - $83K/yr

Full-time

Posted 24 days ago

Job description

The Indemnity Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Receives claims, confirms policy coverage and acknowledgment of the claim
  • Determines validity and compensability of the claim
  • Establishes reserves and authorizes payments within reserving authority limits
  • Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision
  • Communicates claim status with the customer, claimant and client
  • Adheres to client and carrier guidelines and participates in claims review as needed
  • Assists other claims professionals with more complex or problematic claims as necessary
  • Additional duties as assigned

KNOWLEDGE & SKILLS:

  • Excellent written and verbal communication skills
  • Ability to learn rapidly to develop knowledge and understanding of claims practice
  • Ability to identify, analyze and solve problems
  • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
  • Strong interpersonal, time management and organizational skills
  • Ability to meet or exceed performance competencies
  • Ability to work both independently and within a team environment

EDUCATION & EXPERIENCE:

  • Bachelor's degree or a combination of education and related experience
  • Minimum of 1 year of industry experience and claims management preferred
  • State Certification as an Experienced Examiner

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $51,807 – $83,551

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

Our company does not discriminate against applicants on the basis of their race, color, national origin, religion, creed, disability, age, sex, sexual orientation, gender identity, marital status, familial status, or status with regard to public assistance, or membership or activity in a local human rights commission. Copies of job postings will be kept on file.

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