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Remote Medicare Claims Processing Jobs in Virginia

Sentara Health

Benefits Coding Analyst

Richmond, VA · Remote

$10K/mo

This position is remote however, candidates must be able to commute to our Richmond location. The ... within reimbursement, coding, claims processing, claims auditing and /or various payment ...

USAA

Claims Litigation Manager- Section II

Chesapeake, VA · On-site +1

$85K - $162K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Applies intermediate knowledge of claims litigation processes under the Homeowner/Renter Policy ...

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All JobsMedicare Claims Processing JobsRemote Medicare Claims Processing JobsRemote Medicare Claims Processing Jobs in Virginia

Remote Medicare Claims Processing information

What is remote Medicare claims processing?

Remote Medicare claims processing involves reviewing, verifying, and submitting medical claims to Medicare from a location outside of a traditional office, often from home. Professionals in this role ensure that healthcare providers are reimbursed for services rendered to Medicare patients by checking claims for accuracy, compliance, and eligibility. They use specialized software to process electronic and paper claims, resolve discrepancies, and follow up on denied or delayed payments. This job requires knowledge of Medicare regulations, coding, and strong attention to detail. Remote work allows for flexible scheduling but also demands self-discipline and secure handling of sensitive patient data.

What are the key skills and qualifications needed to thrive as a remote Medicare claims processor?

To thrive as a Remote Medicare Claims Processor, you need strong attention to detail, knowledge of medical billing and coding, and a solid understanding of Medicare regulations, often supported by a relevant certification like CPC or CCA. Familiarity with claims processing software, electronic health record (EHR) systems, and Medicare-specific platforms such as the Fiscal Intermediary Standard System (FISS) is typically required. Strong organizational skills, effective written communication, and problem-solving abilities help you excel in remote work environments. These skills ensure timely and accurate claims processing, minimize errors, and support compliance with complex healthcare regulations.

What are some common challenges faced by remote Medicare claims processors and how can they be managed?

One common challenge for remote Medicare claims processors is staying up-to-date with frequent changes in Medicare regulations and billing codes. Additionally, working remotely can make it harder to quickly clarify complex cases with colleagues or supervisors. To manage these challenges, it's important to participate in regular training sessions, utilize internal communication platforms for collaboration, and maintain organized documentation. Employers often provide digital resources and support channels to help remote processors stay connected and informed.

What is the difference between Remote Medicare Claims Processing vs Remote Medical Billing Specialist?

AspectRemote Medicare Claims ProcessingRemote Medical Billing Specialist
CertificationsCPAR, CPC, or similarCPB, CPC, or similar
Work EnvironmentHealthcare insurance, government programsHealthcare providers, clinics, hospitals
Job FocusSubmitting and managing Medicare claimsBilling for various medical services and insurance

Remote Medicare Claims Processing involves handling claims specifically for Medicare, focusing on government regulations and Medicare-specific procedures. Remote Medical Billing Specialists manage billing for a variety of insurance types and healthcare providers. While both roles require similar certifications and work remotely in healthcare settings, Medicare Claims Processing is specialized in government insurance claims, whereas Medical Billing covers broader insurance billing tasks.

What are the most commonly searched types of Medicare Claims Processing jobs in Virginia?

The most popular types of Medicare Claims Processing jobs in Virginia are:

What are popular job titles related to Remote Medicare Claims Processing jobs in Virginia?

For Remote Medicare Claims Processing jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Remote Medicare Claims Processing jobs in Virginia look for?

The top searched job categories for Remote Medicare Claims Processing jobs in Virginia are:

What cities in Virginia are hiring for Remote Medicare Claims Processing jobs?

Cities in Virginia with the most Remote Medicare Claims Processing job openings:

Remote Medicare Claims Processing jobs near you
Infographic showing various Remote Medicare Claims Processing job openings in Virginia as of August 2026, with employment types broken down into 89% Full Time, 7% Part Time, and 4% Contract. Highlights an 100% Remote job distribution.

Benefits Coding Analyst

Sentara Health

Richmond, VA • Remote

$10K/mo

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 6 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 417 frontline employees who took The Breakroom Quiz

499th of 898 rated healthcare providers

Job description

City/State
Richmond, VA
Work Shift
First (Days)
Overview:
Sentara Health is looking to hire a Remote Benefits Coding Analyst.
This position is remote however, candidates must be able to commute to our Richmond location.
The Benefits Coding Analyst - Certified Professional Coder maintains the integrity of the plan benefits for each program and is responsible for developing an extensive expertise of all plan benefits. The Benefits Coding Analyst will work closely with multiple teams across the Health Plan, including but not limited to Claims, Compliance, Program, IT, and Health Services/Medical Management to ensure benefits are compliant with state and Federal guidelines, as well as aligned with Program benefit offerings. This position is responsible for synthesizing the input from multiple stakeholders to inform significant business decisions regarding benefit implementation as well as coordinating and maintaining benefit design documentation for the organization. The Benefits Coding Analyst will research, code, and assist with the development of benefit and utilization review policies and criteria for emerging treatments, technology, medications, and health plan services. This role will assist in researching code updates, authorization requests, and claim questions, updating business rules and benefit repositories as appropriate.
Education:
  • Associate Degree in Healthcare (preferred)

Certification:
• Certified Professional Coder certification (CPC) (required)
• Certified Inpatient Coder (CIC) (preferred)
• Medical Assistant Certification (preferred)
Note: CIC is required for advancement to Level 2 and Level 3
Experience:
• 2+ years of medical coding or billing experience specifically within reimbursement, coding, claims processing, claims auditing and /or various payment methodologies (required)
• Experience in both established benefit coding environments as well as experience in determination of coding requirements for new benefits (preferred)
• Experience resolving billing and claims issues related to benefit to code assignment.
•Thorough knowledge of anatomy and medical terminology
• Expertise with NCCI (National Correct Coding Initiative) guidelines
• Knowledge or direct experience processing Government program or commercial health claims for an MCO
• Experience with ICD-10 CM, CPT, HCPCS, QNXT.
Keywords: Talroo-Allied Health, Healthcare, Coding, CPC, CIC, Billing, Claims, Auditing, ICD-10 CM, CPT, HCPCS, QNXT and Revenue coding in a managed care setting
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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