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Remote Medical Claims Processor Jobs (NOW HIRING)

Sourcedge Solutions

FACETS Claims Processor

Albany, NY · Remote

$17 - $21.25/hr

Remote Reply at: Jobs@sourcedge.com FACETS SENIOR CLAIMS PROCESSOR * 5 Years Facets Claims ... Knowledge of Medical terminology * Computer with 2 Monitors * High Speed Internet Connection

Insperity

Medical Claims Examiner

Los Angeles, CA · On-site +1

$24 - $30/hr

Paid time off, flexible schedule, and remote work choices provided Plus, we work to maintain the ... Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.

Conduent, Inc.

Remote Claims Processor

VA · Remote

$15/hr

Remote Claims Processor Schedule: Flexible shifts between 6:00 AM - 10:30 PM (based on business ... medical condition, use of a guide dog or service animal, military/veteran status, citizenship ...

Insperity

Medical Claims Examiner

CA · On-site +1

$24 - $30/hr

Description & Requirements Medical Claims Examiner- Chatsworth Local Remote or In-Office Join a ... Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.

Insperity

Medical Claims Examiner

CA · Remote

$24 - $30/hr

Description & Requirements Medical Claims Examiner- Chatsworth Local Remote or In-Office Join a ... Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.

Moda Health

Medical Claims COB Processor I

Milwaukie, OR · Remote

$18.39 - $20.58/hr

Minimum of 6 months medical claim processing or customer service dealing with all types of plans/claims and consistently exceeding performance levels. * Professional and effective written and verbal ...

Imagenet

Claims Examiner - Remote

Tampa, FL · Remote

... processing medical claims and provider dispute requests in accordance with payer guidelines ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...

Imagenet

Claims Examiner - Remote

Tampa, FL · On-site +1

... processing medical claims and provider dispute requests in accordance with payer guidelines ... Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... remote, giving you the freedom to work from anywhere! What You'll Do: As a dynamic Claims ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

NTT DATA

Healthcare Claims Processor, Remote

$17.50 - $22/hr

Remote Claims Processing Associate NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this role, the candidate will be responsible for:

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... remote, giving you the freedom to work from anywhere! What You'll Do: As a dynamic Claims ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

Amerita

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... remote, giving you the freedom to work from anywhere! What You'll Do: As a dynamic Claims ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

PharMerica

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

... remote, giving you the freedom to work from anywhere! What You'll Do: As a dynamic Claims ... Prepares and maintains reports and records for processing * Performs other tasks as assigned ...

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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 18, 2026, the average hourly pay for remote medical claims processor in the United States is $19.47, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $21.63 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 top searched job categories for Remote Medical Claims Processor jobs are:

Remote Medical Claims Processor jobs near you
Infographic showing various Remote Medical Claims Processor job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $40,493 per year, or $19.5 per hour.

FACETS Claims Processor

Sourcedge Solutions

Albany, NY • Remote

$17 - $21.25/hr

Contractor

Re-posted 5 days ago

Job description

Location: Remote 
Reply at: Jobs@sourcedge.com
FACETS SENIOR CLAIMS PROCESSOR 
Job Description:
 
  • 5 Years Facets Claims Adjudication Experience
 
  • The Claims Examiner must maintain production and inventory standards compliant with Claims Administration requirements
 
  • High school diploma or equivalent required
 
  • Must have 5+ years of relevant claim processing experience in healthcare industry (managed care or TPA Company) to support our clients
 
  • Possess high productivity and quality standards within a claims processing automation environment
 
  • Knowledge of CPT, HCPC, ICD-10 codes
 
  • Knowledge of HMO, PPO, Medicare and Medicaid plans
 
  • Knowledge of Medical terminology
 
  • Computer with 2 Monitors
 
  • High Speed Internet Connection
 
  • Ability to work remote 8 hour day, Mon-Fri.

Responsibilities:
 
  • The claims examiner is responsible for accurate and timely adjudication of claims for the Health Plans lines of business
 
  • Primary duties include analysis and resolution of claims, including reviewing pended claims and manually resolving based on client specified direction and criteria, including  third-party liability claims
 
  • The claims examiner must be able to work independently, effectively prioritizing work in a production environment that frequently changes to meet production standards and contractual requirements
 
  • Success in this position will be based on the individual's ability to effectively prioritize work, identify, and resolve complex concerns in a professional manner, and work in a team environment to achieve and maintain production and audit standards
 
  • Timely and accurate processing and adjudication of all types of claims from assigned workflow queues
 
  • Compliance with state, federal and contractual requirements to Claims Administration
 
  • Demonstrate a thorough knowledge of the Plan's claims processing procedures as provided in training materials and proficiency with the core and ancillary system applications
 
  • Demonstrates the ability to think analytically to resolve complicated claim issues and identify appropriately when to escalate issues for review
 
  • Ability to review and apply Plan directives and desktop procedures to claims, following step by step guidelines
 
  • Claim analysis of coding and billing compliance, potential third-party liability, accurate coordination of benefits (COB), benefit application including limitations and restrictions, pre-existing conditions, subrogation, medical necessity and other claim investigation as appropriate
 
  • Complete all mandatory claims training/refresher courses
 
  • Actively participates and supports department and organization-wide efforts to improve efficiencies while supporting departmental goals and objectives
 
  • Complete all mandatory compliance and corporate training
 
  • Must be able to adapt to a changing work priorities and requirements and perform other duties as directed to support the overall functions of Claims Administration and support of staff without boundaries within the Plan