ZipRecruiter

Log In

2

Remote Medical Claims Processor Jobs in Utica, MI

BeneSys, Inc.

Claims Analyst (Troy, MI)

Troy, MI · Remote

Level I - Previous claims processing experience necessary. Must have working knowledge of medical ... Applicants for this remote role will only be considered if they live in these locations: Arizona ...

BeneSys, Inc.

Specialty Claims Analyst (Troy, MI)

Troy, MI · Remote

$21 - $24/hr

Applicants for this remote role will only be considered if they live in these locations: Illinois ... Qualifications - Individual must be skilled in medical claims processing and knowledge of medical ...

Tmhcc

Property Claims Adjuster

Troy, MI · On-site +1

Remote / Hybrid (dependent upon on proximity of office location) Reports To: Katie Toman Employment ... The Property Claims Adjuster will also support the subrogation process for claims identified as ...

USAA

Sr. TLE Auto Appraiser

Detroit, MI · On-site +1

$63K - $121K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Maintains accurate and current claim file documentation throughout the claims process for complex ...

next page

Showing results 1-20

All JobsMedical Claims Processor JobsRemote Medical Claims Processor JobsRemote Medical Claims Processor Jobs in Utica, MI

Remote Medical Claims Processor information

See Utica, MI salary details

$12

$17

$23

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

As of Aug 26, 2026, the average hourly pay for remote medical claims processor in Utica, MI is $17.76, according to ZipRecruiter salary data. Most workers in this role earn between $15.77 and $19.76 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 job categories do people searching Remote Medical Claims Processor jobs in Utica, MI look for?

The top searched job categories for Remote Medical Claims Processor jobs in Utica, MI are:

What cities near Utica, MI are hiring for Remote Medical Claims Processor jobs?

Cities near Utica, MI with the most Remote Medical Claims Processor job openings:

Remote Medical Claims Processor jobs near you
Infographic showing various Remote Medical Claims Processor job openings in Utica, MI as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, and 5% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $36,941 per year, or $17.8 per hour.

Claims Analyst (Troy, MI)

BeneSys, Inc.

Troy, MI • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 14 days ago

BeneSys rating

7.8

Company rating: 7.8 out of 10

Based on 11 frontline employees who took The Breakroom Quiz

154th of 496 rated business services

Job description

Claims Analyst (Troy, MI)
Summary – The Claims Analyst will be responsible for medical, dental, and vision claims processing of claims submitted electronically or on hard copy. Each Analyst will specialize in a particular group but is expected to handle claims processing for multiple groups.
Applicants for this remote role will only be considered if they live in these locations: Arizona, California, Colorado, Washington DC, Iowa, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Michigan, Missouri, Nevada, Ohio, Oregon, Pennsylvania, Texas, Utah, Washington, Wisconsin.
Essential Duties and Responsibilities include but not limited to
  • Review claims for benefit determination based on exception reports of electronic claim submission or hard copy submissions.
  • Make corrections when necessary to incorrect participant or provider data.
  • Assist Client Services Representatives with difficult claim adjustments/corrections.
  • Analyst must be able to determine benefits for multiple groups and process claims accurately according to the corresponding Plan Documents.
  • Primary responsibilities will not include telephone or personal interaction with participants or providers unless; it is determined by a supervisor or manager that assistance is needed in this area.
  • Regular and predictable attendance is an essential function of this job.
Claim Analyst Levels
  • Level I – Previous claims processing experience necessary. Must have working knowledge of medical terminology, CPT, ICD9/10, and HCPCS codes as well as CMS1500 and CMS1450 claim forms. Must be detail-oriented, work well independently and part of a team, self-motivated, possess analytical skills and ability to make benefit determinations utilizing plan documents. Must meet established productivity and quality expectations of 98% procedural and 99% payment/financial accuracy. Ability to process specialty claims such as flexible spending and HRAs.
  • Level II – Must be proficient at all Level I skills. Complete understanding of claims processing system and assigned funds. Demonstrated ability to process all claim types and resolve complex claims including but not limited to Coalition and Hospitalist claims. Sound understanding of all aspects of the adjustment process. Ability to assist with system testing and claims auditing. Demonstrates initiative, sound judgment, and independent decision-making ability.
  • Level III – Must be proficient at all Level I and II skills. Solid understanding of all claim types and the ability to assist on all funds. Ability to identify inconsistencies and escalate findings appropriately. Excellent communication skills. Ability to train and assist new hires as well as provide support for Analyst I and II’s. Conduct audits, report findings, provide detailed analysis of claims, and recommend changes for process improvement.
  • Unit Lead - Must be proficient at all Level I - III skills. Must possess leadership ability and excellent communication skills both verbally and in writing. Demonstrates the ability to understand and facilitate the resolution of all complex claims issues including adjustments and appeals. Provide training to new hires and existing staff. Complete reporting for inventory, department, and individual analysts’ performance stats. Monitors inventory to ensure turn-around-times are maintained and department goals are achieved. Identifies error trends for training needs and works with the supervisor for implementation of processes to improve overall performance. Must demonstrate initiative, ability to multi-task and prioritize, and excellent organizational skills. Ability to represent the department on workgroups and new system implementation.
Qualifications - Individual must have previous medical claims processing experience and knowledgeable of medical terminology (i.e., CPT codes, ICD-9 codes, HCPCS, ADA codes). Analyst must be methodical and possess the skills to determine approval for benefit payment, versus pending or denying. Analyst will be accountable for benefit determinations. Excellent customer service skills are a must.
Applicants for this remote role will only be considered if they live in these locations: Arizona, California, Colorado, Washington DC, Iowa, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Michigan, Missouri, Nevada, Ohio, Oregon, Pennsylvania, Texas, Utah, Washington, Wisconsin.
Education and/or Experience - High School diploma or GED equivalent and two years related experience.
Language Skills - Ability to read and interpret documents such as Summary Plan Descriptions of Plan rules. Ability to communicate professionally and clearly with other departments of BeneSys.
Mathematical Skills - Ability to apply concepts of basic addition, subtraction, multiplication and division.
Reasoning Ability - Ability to apply common sense to carry out detailed written or oral instructions.
Work Schedule - Full-time. Monday – Friday, 7:30am - 4:00pm. Permanent Remote position (No in-office days).
Competitive Benefits and Compensation Package
  • 15 days Paid Time Off (PTO) during first full calendar-year of service
  • 12 paid holidays
  • 3 days paid bereavement
  • Up to 20 days paid jury leave
  • Medical, dental, and vision insurance, with option for dependent coverage
  • Company-paid basic life, short-term disability, long-term disability, and AD amp;D insurance
  • 401k with employer match
  • Tuition reimbursement program
  • Career development opportunities
  • Referral bonus for all successful full-time referrals
  • Annual opportunities for increases
Pay - Hourly rate ranges from $25.00 - $27.00. Actual rate dependent on location, skills, education, experience and other business factors.
Our Culture
BeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees. In short, our success is driven by our employees’ successes. We want to be a place where people want to work, feel proud of what they do and feel fulfilled both professionally and personally. We want to create a place where employees can find long-term growth and potential.
Our culture focuses on three core values:
  • Collaboration: working together across 31 locations to achieve the best for the company and our clients
  • Dedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleagues
  • Integrity: doing what we say we will do. Upholding strong ethical and moral principles
ADA amp; EEO
Reasonable accommodations will be made so that qualified individuals with disabilities are able to complete the application process and, if hired, fulfill the essential functions of their job.

What BeneSys employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

BeneSys logo

About BeneSys

Sourced by ZipRecruiter

Industry

Insurance and employee benefit funds

Company size

501 - 1,000 Employees

Headquarters location

Troy, MI, US

Year founded

1979

View All BeneSys Jobs

Apply