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Remote Medical Claims Processor Jobs in Sun Prairie, WI

WPS

Appeals Registered Nurse

Madison, WI · On-site +1

$30.50 - $40.25/hr

  • Medical

  • Dental

  • Retirement

  • PTO

Role Snapshot The Appeals Nurse examines medical records and claims information for first-level ... Work Location We are open to remote work in the following approved states: Colorado, Florida ...

WPS Health Solutions

Appeals Registered Nurse

Madison, WI · On-site +1

  • Medical

  • Dental

  • Retirement

  • PTO

Role Snapshot The Appeals Nurse examines medical records and claims information for first-level ... Work Location We are open to remote work in the following approved states: Colorado, Florida ...

Saige Partners

IT Business Analyst

Madison, WI · On-site +1

... Claims Center) Location: Madison, WI or Chicago, IL or Atlanta, GA | Hybrid or Remote U.S ... Promote process improvements, reporting automation, and scalable self-service reporting ...

Quartz Health Solutions

Senior Quality Analyst

Madison, WI · Remote

$66K - $83K/yr

  • Medical

Extensive experience with complex claims processing and auditing * Strong understanding of medical coding standards and guidelines * Proven knowledge of provider reimbursement methodologies (e.g ...

Quartz

Senior Quality Analyst

Madison, WI · Remote

$66K - $83K/yr

  • Medical

Extensive experience with complex claims processing and auditing * Strong understanding of medical coding standards and guidelines * Proven knowledge of provider reimbursement methodologies (e.g ...

Natus Medical Incorporated

Product Manager EMG

Middleton, WI · On-site +1

$120K - $130K/yr

  • Medical

  • Retirement

  • PTO

US Remote Position Overview The Product Manager-EMG owns the positioning and success of assigned ... process from Gate 1 through Gate 6 • Take ownership of marketing design inputs (MDI) for NPI and ...

Agrace

Benefit & Compensation Analyst (on site)

Madison, WI · Remote

$70K - $87K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Madison, WI Full Time | Day | Monday-Friday | 8am-5pm (option for 1 Day/Week remote) Make a lasting ... processes and provide input on claims issues. * Oversee Wisconsin and Federal Family Medical Leaves ...

Urrly

Telehealth Nurse Practitioner (Remote)

Madison, WI · Remote

$600 - $720/hr

Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ... Clear documentation processes Schedule & Setup * Minimum 24 hours weekly * Flexible scheduling ...

Corvel

Care Advocate Nurse

Madison, WI · Remote

$61K - $98K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... medical data in CareMC, validates and secures medical information, assesses and evaluates ... Claims Management department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS ...

WPS

Provider Network Reimbursement Analyst

Madison, WI · On-site +1

  • Medical

  • Dental

  • Retirement

  • PTO

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 ...

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Showing results 21-40

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

As of Aug 16, 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.

More about Remote Medical Claims Processor jobs

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

Medical Microbiology Consultant - Remote

micro1 AI

Madison, WI • Remote

$70 - $90/hr

Part-time

Posted 19 days ago

Job description

Role Title: Microbiologist


Role Type: Contractor


Location: Remote


micro1 is engaging Microbiologists to contribute their scientific expertise to a unique customer project. In this role, you'll apply your expertise to help train next-generation AI systems. Your work will shape how models learn, reason, and perform through high-quality, real-world input. No prior experience in AI is required — your domain knowledge is what matters.


Key Responsibilities:

  1. Investigate and analyze the development, morphology, and behavior of microscopic organisms including bacteria, fungi, and algae.
  2. Contribute to the study of the relationship between microorganisms and disease, supporting projects involving medical microbiology.
  3. Assess the impact of antibiotics and other agents on microbial populations, providing insights for AI model accuracy.
  4. Document experimental findings and processes with a focus on clarity for AI training data.
  5. Collaborate with interdisciplinary teams to ensure scientific rigor and data integrity in AI development.
  6. Provide written and verbal expertise on microbiological phenomena and their relevance to real-world and computational contexts.
  7. Utilize rubrics and established evaluation criteria to assess data quality and support AI training workflows.


Required Skills and Qualifications:

  1. Bachelor’s degree or higher in Biology, Microbiology, Chemistry, or a related field.
  2. Extensive knowledge of bacterial, fungal, and algal systems.
  3. Demonstrated expertise in investigating microbial structure and physiology.
  4. Strong written and verbal communication skills for technical and interdisciplinary collaboration.
  5. Ability to document processes and findings clearly for integration into AI systems.
  6. Comfort working independently in a fully remote, digital-first environment.
  7. Attention to detail and commitment to scientific accuracy.


Preferred Qualifications:

  1. Prior experience developing or applying rubrics in scientific or educational contexts.
  2. Experience with AI, machine learning, or annotation projects related to biology or microbiology.
  3. Advanced degree (Master’s or PhD) in a relevant field.

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