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Remote Medical Claims Processor Jobs in Tyler, TX

micro1 AI

Medical Billing Specialist

Tyler, TX · 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 Writing Manager

Tyler, TX · 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

AI Trainer - Microbiology Expert

Tyler, TX · Remote

$70 - $90/hr

Remote micro1 is engaging Microbiologists to contribute their scientific expertise to a unique ... Document experimental findings and processes with a focus on clarity for AI training data.

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Remote Medical Claims Processor information

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

As of Aug 20, 2026, the average hourly pay for remote medical claims processor in Tyler, TX is $18.35, according to ZipRecruiter salary data. Most workers in this role earn between $16.30 and $20.38 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
Infographic showing various Remote Medical Claims Processor job openings in Tyler, TX as of August 2026, with employment types broken down into 33% Full Time, 33% Part Time, and 34% Contract. Highlights an 100% Remote job distribution, with an average salary of $38,158 per year, or $18.3 per hour.

Workers' Compensation Claims Representative

Claims Administrative Services, Inc.

Tyler, TX • Remote

Full-time

Medical

Re-posted yesterday

Job description

About Us

Claims Administrative Services, Inc (CAS) has served as a third-party administrator handling workers' compensation and property and casualty claims for a wide array of clients since 1990. In addition to our claims experience, CAS offers safety and loss control, cost containment services, and program administration. Every day our experienced professionals are on the job, reducing the frequency and severity of workplace injuries, managing associated claims costs, and helping injured employees return to work. Our personalized customer service combined with dedicated experience, innovation, and cost efficiency, assists our clients in reducing costs and protecting their employees.

Structure and Ownership

Heartland Security Insurance Group is the holding company for Claims Administrative Services, Inc. Heartland is comprised of seven different insurance and risk management businesses, providing products and services globally. Each of the companies offer solutions to distinct client groups in the federal, state and private sectors. The organization has been under continuous private family ownership for 50 years. Today, it has over 60 stockholders as well as ESOP ownership. In addition to providing an important retirement benefit to associates, the Employee Stock Ownership Plan (ESOP) assures that everyone in the organization has a vested interest in providing the very highest level of service to the client.

Commitment to the Community

Claims Administrative Services, Inc., and the parent organization, Heartland Security Insurance Group, have a long history of philanthropy to the local, national, and international communities.

Workers' Compensation Claims Representative

Primary Responsibility

The Claims Representative will manage an assigned caseload of medical only and lost time Workers’ Compensation claims from the first report of injury to resolution according to the applicable law. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements. The role interacts with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claims management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers. The Claims Representative will adjudicate medical only and lost time Workers' Compensation files according to applicable law.

Essential Functions & Responsibilities

Manage assigned caseload of workers’ compensation claims.

Make decisions about compensability, set reserves and negotiate settlements.

Interact with claimants, clients, medical providers and other third party representatives throughout the claims process.

Timely initial contacts and investigation of new claims.

Verify coverage.

Take recorded statements as needed.

Document files daily on every conversation and action taken.

Identify and address subrogation issues.

Start and stop indemnity benefits timely and accurately.

Complete jurisdictional forms timely and accurately.

Monitor ongoing medical treatment.

Request second medical opinions as needed.

Request surveillance appropriately.

Work mail and diary on a daily basis.

Client visits as required.

Preparation and handling of hearings

Additional Functions & Responsibilities

Communicates directly with client.

Prepares reports and other analytical data as requested by the management team.

Required Qualifications

Must hold a valid Workers’ Compensation Adjuster license.

Must have at least 2-3 years of experience handling indemnity workers’ compensation claims.

High school diploma.

Ability to follow instructions, procedures and rules.

Must have strong attention to detail.

Must have good written and oral communication skills.

Must be well organized and the ability to multi-task.

Basic computer skills in MS Word, Excel and Outlook.

Fast, accurate data entry

Preferred Qualifications

College degree in business or other related discipline.

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