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Remote Medical Claims Processor Jobs in Sun Prairie, WI

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

Senior Quality Analyst

Madison, WI · Remote

$66K - $83K/yr

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

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

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

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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

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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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Remote Medical Claims Processor jobs near you

Medical Writer / Clinical Document Author

micro1 AI

Madison, WI • Remote

$50 - $80/hr

Part-time

Re-posted 4 days ago

Job description

Role Title: Medical Writer / Clinical Document Author


Role Type: Contractor


Location: Remote


micro1 is engaging Medical Writers / Clinical Document Authors to participate in a customer’s project focused on developing advanced AI-assisted writing tools for clinical documentation. 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.


Scope of Work

  1. Author and review realistic evaluation tasks based on Clinical Study Reports, DSURs, PSURs/PBRERs, and related clinical documents to inform AI tool development.
  2. Apply expert judgment to assess whether AI-generated content fulfills clinical template and structural requirements, including ICH E3 organization, section sequencing, cross-referencing, and appendix management.
  3. Evaluate scientific accuracy in narrative sections such as efficacy, safety summaries, discussion, and conclusions, distinguishing true scientific or interpretive errors from stylistic differences.
  4. Trace narrative claims to source records—tables, figures, listings, and protocols—to verify that all assertions are appropriately supported.
  5. Provide clear and structured written rationales for each assessment, enabling precise diagnosis and improvement of AI model behavior.
  6. Collaborate with project leads to refine evaluation frameworks and document best practices for clinical regulatory writing in the context of AI.


Preferred Qualifications

  1. Minimum 5 years of regulatory medical writing experience at a sponsor, CRO, or as an independent consultant.
  2. Direct experience independently authoring or leading the authoring of full Clinical Study Reports, beyond summaries or partial contributions.
  3. Fluency with ICH E3 and conventions for periodic safety documentation (ICH E2F, ICH E2C) and eCTD placement.
  4. Demonstrated ability to read and interpret TFLs and protocol documents, identifying where narrative diverges from source data.
  5. Exceptional written and verbal communication skills, especially in providing structured, actionable feedback on clinical content.
  6. Advanced degree in life sciences, pharmacy, or medicine (PhD, PharmD, MD, MSc), or equivalent depth of authoring experience.
  7. Experience across multiple clinical phases and therapeutic areas; oncology and haematology expertise is especially valued.


Join our customer's team and leverage your authoring expertise to help design the next generation of AI-assisted clinical documentation solutions. This high-bar role offers you the chance to shape how tomorrow's writing teams draft and review regulatory documents — through your expert input, judgment, and real-world experience.

Apply