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Remote Medical Claims Processor Jobs in Sun Prairie, WI

Foth

Mechanical Process Engineer (Utilities)

Madison, WI · On-site +1

$100K - $150K/yr

While we prefer that this individual work out of our Green Bay office, we are open to remote ... Eligible full-time and part-time members will be offered medical, dental, vision insurance ...

Foth

Mechanical Process Engineer (Utilities)

Madison, WI · Remote

$100K - $150K/yr

While we prefer that this individual work out of our Green Bay office, we are open to remote ... Eligible full-time and part-time members will be offered medical, dental, vision insurance ...

Foth

Mechanical Process Engineer (Utilities)

Madison, WI · On-site +1

$100K - $150K/yr

While we prefer that this individual work out of our Green Bay office, we are open to remote ... Eligible full-time and part-time members will be offered medical, dental, vision insurance ...

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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 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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Remote Medical Claims Processor jobs near you

Splunk Enterprise Security (ES) Consultant - remote

System One

Arlington, WI • Remote

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 14 days ago

Job description

Splunk Enterprise Security (ES) Consultant - remote Remote – offsite Responsibilities
  • Develop custom detection content: correlation searches, notable events, alerts, reports, and visualizations to surface threat activity
  • Build and maintain Splunk Apps and Technology Add-ons (TAs)
  • Onboard new data sources and normalize them to the Common Information Model (CIM)
  • Optimize data flow and ingestion using aggregation, filtering, and pipeline tuning
  • Configure notable event actions, action menus, and Adaptive Responses
  • Tune detections to cut noise and surface what matters, including risk-based alerting where applicable
  • Build dashboards that highlight anomalies, trends, and security and operational metrics
  • Support and optimize large distributed clustered Splunk environments (search heads, indexers, forwarders, deployment servers)
  • Partner with the client's security and SOC teams, debug complex integration and configuration issues
  • Document processes, procedures, and key engineering decisions
Requirements
  • Several years of hands-on Splunk experience, with real ES implementation, content development, and tuning
  • Strong SPL and regular expressions
  • Scripting in Python, Perl, or Bash
  • Solid grasp of CIM and data onboarding and normalization at scale
  • Experience supporting clustered Splunk environments in SOC or NOC settings
  • SIEM data modeling experience on a platform at scale
  • Proficiency in Linux, including editing and maintaining Splunk config files and apps
  • Comfortable working consultatively with client teams and explaining the why behind the work
  • Splunk certifications (Core Certified Consultant, ES Certified Admin, Architect) are a plus but not required
  • Demonstrated ES delivery experience carries more weight than paper
System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan. System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law. #LI-KA1 #M1

Ref: #856-Baltimore-S1

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About System One

Sourced by ZipRecruiter

System One helps employers get work done more efficiently and economically without compromising quality. Over our 35+ year history, we've helped connect thousands of talented people with innovative companies. The excitement of a perfect fit motivates us every single day.

Industry

Business consulting services and recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Pittsburgh, PA, US

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