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Work From Home Claims Examiner Jobs (NOW HIRING)

Imagenet

Claims Examiner - Remote

Tampa, FL · Remote

This is a fully remote position Work Hours:Pacific Time Zone We are looking for Experienced Claims Examiner to join our rapidly growing team. Experience is required for this position. Job Overview:

Addison Group

Life Claims Examiner

Mckinney, TX · Remote

$20 - $23/hr

Remote, working hours within Central Time Zone Work Schedule: M-F, 7:00 am - 4:00 pm Type of ... This role is responsible for reviewing and handling claims from start to finish, ensuring accuracy ...

LIO Insurance

Claims Examiner (Casualty)

Conshohocken, PA · On-site +1

$68K - $123K/yr

The Claims Examiner - Casualty is accountable for managing a portfolio of moderate complexity ... Ownership mindset, with the ability to plan, organize, and execute work from initiation through ...

Auxiant

Claims Examiner

Madison, WI · On-site +1

Answer inbound phone calls from members and providers. * Handle correspondence from members and ... Work Customer Service Tickets. Nonessential Functions: * Other duties as assigned or appropriate ...

Imagenet

Claims Examiner - Remote

Tampa, FL · On-site +1

This is a fully remote position Work Hours: Pacific Time Zone We are looking for Experienced Claims Examiner to join our rapidly growing team. Experience is required for this position. Job Overview:

woodmenlife

Claims Examiner I or II

Makes calls to Funeral Homes verifying needed information in order to process claims with face ... The ability to work with little or no direction from Senior Examiner or Supervisor. * Prefer 2+ ...

LIO Insurance

Claims Examiner (Casualty)

Richmond, VA · On-site +1

$68K - $123K/yr

The Claims Examiner - Casualty is accountable for managing a portfolio of moderate complexity ... Ownership mindset, with the ability to plan, organize, and execute work from initiation through ...

RENFROE (Roster)

Commercial Claims Examiner

... work from home or work from a centralized office • Regular attendance required, working up to 12 hours a day, 7 days a week, for extended periods of time, including weekends and holidays • ...

Insperity

Medical Claims Examiner

CA · Remote

$24 - $30/hr

Well-being and work-life balance: Paid time off, flexible schedule, and remote work choices ... To thrive as the Medical Claims Examiner, you should have: * Minimum of 2 years of medical claims ...

TEEMA Group

Claims Examiner III

Irving, TX · Remote

$76K - $85K/yr

Manage loss-time Workers' Compensation claims within Texas jurisdiction from inception through ... Location & Work Type On-site position in an office environment. Full-time, exempt role. Regular in ...

Berkley

Claims Examiner I

Scottsdale, AZ · On-site +1

Our flexible work schedule with a work-from-home day means you can balance work and life like a pro ... The Claims Examiner I's primary job function includes efficiently and effectively handling ...

WoodmenLife

Claims Examiner I or II

Omaha, NE · On-site +1

$17 - $25/hr

Makes calls to Funeral Homes verifying needed information in order to process claims with face ... The ability to work with little or no direction from Senior Examiner or Supervisor. * Prefer 2+ ...

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Work From Home Claims Examiner information

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$15

$29

$45

How much do work from home claims examiner jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for work from home claims examiner in the United States is $29.40, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.10 per hour, depending on experience, location, and employer.

What is a work from home claims examiner?

Work From Home Claims Examiners are professionals who review insurance claims to determine their validity and ensure compliance with policy terms, all while working remotely. They analyze claim forms, supporting documents, and sometimes communicate with claimants or medical professionals to gather additional information. These examiners may work for health, auto, property, or other types of insurance companies. Their remote role allows for flexibility, but requires strong attention to detail, confidentiality, and effective communication skills.

What does a work from home claims examiner do?

A work from home claims examiner is an insurance professional who works from a remote location outside of a traditional office. In this position, your responsibilities include evaluating insurance applications and claims as well as examining files submitted by an insurance adjuster. Your duties are to review submitted claims to understand coverage, ensure compliance with company policies and procedures, and help complete the process for a settlement. You may also work with other professionals on a large or complex case with a substantial payout to provide expertise and determine accuracy. You may find employment in a variety of insurance-related industries, including medical, automotive, and real estate.

What are the key skills and qualifications needed to thrive as a work from home claims examiner?

To excel as a Work From Home Claims Examiner, you need a solid understanding of insurance policies, claims processing, and attention to detail, often supported by a degree in business, finance, or a related field. Familiarity with claims management software, electronic documentation systems, and sometimes certifications like AIC (Associate in Claims) are typically required. Strong analytical thinking, self-motivation, and excellent written communication are crucial soft skills for remote collaboration and efficient case resolution. These competencies are vital for ensuring accurate, timely claim decisions and maintaining high standards of customer service from a remote environment.

How does a work from home claims examiner typically collaborate with other departments while working remotely?

As a Work From Home Claims Examiner, collaboration with other departments such as underwriting, customer service, and medical review teams is primarily conducted through digital communication platforms like email, instant messaging, and video conferencing. Regular virtual meetings and shared document systems help ensure accurate claims processing and timely resolution of issues. You'll often work closely with your supervisor and cross-functional teams to clarify claims details, escalate complex cases, and maintain consistent workflow. Effective remote communication and organization are key to successfully collaborating in this role.
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Work From Home Claims Examiner jobs near you
Infographic showing various Work From Home Claims Examiner job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

Claims Examiner - Remote

Imagenet

Tampa, FL • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 5 days ago

Key responsibilities

  • Review, investigate, and process medical claims and provider dispute requests in accordance with guidelines, agreements, and policies.

  • Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.

  • Communicate with internal resources and stakeholders to resolve claim discrepancies, request additional information, or clarify issues.

Job description

Claims Examiner - Remote


Job Type: Full-time

Work Setup: This is a fully remote position
Work Hours:Pacific Time Zone


We are looking forExperienced Claims Examiner to join our rapidly growing team.

Experience isrequiredfor this position.


Job Overview:

As a Claims Examiner, you will be responsible for accurately reviewing, investigating, and processing medical claims and provider dispute requests in accordance with payer guidelines, contractual agreements, regulatory requirements, and internal policies.


Responsibilities:

  • Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.
  • Review and investigate provider dispute requests, appeals, and reconsiderations related to processed medical claims.
  • Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
  • Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues.
  • Participate in ongoing training and professional development activities.
  • Maintain accurate and detailed records of claims processing activities.
  • Review claim forms and supporting documents
  • Determine eligibility, verify data accuracy
  • Request additional information when needed
  • Process claims end-to-end
  • Identify and escalate complex or unusual claims for further review or investigation.
  • Participate in ongoing training and professional development activities.
  • Handle more complex claims with multiple services, providers


Experience:

  • At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment.
  • Experience processing Provider Dispute Resolution (PDR), appeals, reconsiderations, or claim adjustments is highly preferred.
  • Understanding of health claims processing/adjudication
  • Ability to perform basic to intermediate mathematical computation routines
  • Medical terminology strongly preferred
  • Understanding of ICD-9 & ICD-10
  • Basic MS office computer skills
  • Ability to work independently or within a team
  • Time management skills
  • Written and verbal communication skills
  • Attention to detail
  • Must be able to demonstrate sound decision-making skills


What We Offer

  • Remote work offered
  • Equipment provided
  • Paid trainingto set you up for success
  • Comprehensive benefits:Medical, Dental, Vision, Life, HSA, 401(k)
  • Paid Time Off (PTO)
  • 7 paid holidays
  • A supportive team and a company that values internal growth


Ready to Grow Your Career?

We'd love to meet you! Click"Apply Now"and tell us why you'd be a great addition to the Imagenet team.


About Imagenet

Imagenet is a technology-forward healthcare operations partner with more than 25 years of experience helping healthcare payers manage critical administrative and operational processes. Founded in 2000 and headquartered in Tampa, Florida, Imagenet supports 150+ health plans through its payer clients.


Our teams help improve efficiency, accuracy, visibility, and service across complex healthcare operations, including digital mailroom, claims adjudication, contact center, member communications, and related administrative functions. By combining experienced operational teams, proven processes, and purpose-built workflow technology, Imagenet helps payers keep essential processes moving for the members, providers, and communities they serve.


Imagenet operates 10 secure facilities across the U.S. and one secure facility in Manila, Philippines.


Joining Imagenet means contributing to work that supports the healthcare operations members and providers rely on every day.

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