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Work From Home Medical Claim Review Jobs (NOW HIRING)

CVS Health

Medical Claim Analyst

$18.50 - $38.82/hr

... review to the CCR clinicians and medical directors. -Organizes and prioritizes work to help meet regulatory and CCR claim turnaround times. Determines coverage, verifies eligibility, benefits ...

Reliant Medical Group

IRR Clinical Claim Review | , |

$29 - $52/hr

Experience working with medical terminology and coding * Proven ability to work independently ... The hourly pay for this role will range from $29 - $52 per hour based on full-time employment. We ...

UMR

IRR Clinical Claim Review | , |

$29 - $52/hr

Experience working with medical terminology and coding * Proven ability to work independently ... The hourly pay for this role will range from $29 - $52 per hour based on full-time employment. We ...

UnitedHealthcare

Clinical Claim Review | , |

This position will utilize information from claims data analysis, plan members, the medical ... You will have the flexibility to work remotely* as you take on some tough challenges. Primary ...

IQVIA

Work from Home

Colorado Springs, CO · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Little Rock, AR · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Grand Junction, CO · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Boise, ID · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Tucson, AZ · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

SYDIERA

Medical Biller

New York, NY · On-site +1

$20 - $25.75/hr

Remote (Work From Home) Job Type: Independent Contractor (1099) Schedule: Flexible | Part-Time and ... This is a remote, independent contractor opportunity involving medical claim processing, coding ...

IQVIA

Work from Home

Littleton, CO · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Indianapolis, IN · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Cleveland, OH · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Cincinnati, OH · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Fort Collins, CO · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Denver, CO · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Fort Collins, CO · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

IQVIA

Work from Home

Birmingham, AL · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

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Work From Home Medical Claim Review information

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How much do work from home medical claim review jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for work from home medical claim review in the United States is $22.21, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $24.52 per hour, depending on experience, location, and employer.

What is a work from home medical claim review?

A Work From Home Medical Claim Review job involves evaluating medical insurance claims to ensure accuracy, completeness, and compliance with policy guidelines. Professionals in this role review medical records, verify billing codes, and determine whether claims should be approved, denied, or escalated. It requires attention to detail, knowledge of medical terminology, and familiarity with insurance industry regulations. Many positions require experience in medical coding, billing, or claims processing. This role is typically remote, allowing employees to work from home while using secure company systems to access claim information.

What are the key skills and qualifications needed to thrive in work from home medical claim review?

To thrive as a Work From Home Medical Claim Review professional, you need strong knowledge of medical terminology, health insurance policies, and claim adjudication processes, often supported by experience or certification such as CPC or CPAR. Familiarity with medical billing software, claims management systems, and secure remote work platforms is typically required. Exceptional attention to detail, analytical thinking, and effective written communication are valuable soft skills for this role. These competencies ensure accuracy, timely claim processing, and effective collaboration in a remote environment.

What are some common challenges faced by work from home medical claim review professionals, and how can they be overcome?

Work From Home Medical Claim Review professionals often encounter challenges such as interpreting complex medical records, staying current with evolving insurance regulations, and effectively managing workloads without in-person supervision. To overcome these obstacles, it's important to utilize continued training resources, maintain clear communication with team members via virtual channels, and develop strong time management skills. Access to updated reference materials and regular virtual meetings with supervisors can also help address questions and enhance job performance. Being proactive in seeking support and clarification when needed fosters accuracy and efficiency in claims review.

More about Work From Home Medical Claim Review jobs

What cities are hiring for Work From Home Medical Claim Review jobs?

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What states have the most Work From Home Medical Claim Review jobs?

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Work From Home Medical Claim Review jobs near you
Infographic showing various Work From Home Medical Claim Review 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 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $46,198 per year, or $22.2 per hour.

Medical Claim Analyst

CVS Health

Remote

$18.50 - $38.82/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 7 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,341 frontline employees who took The Breakroom Quiz

91st of 113 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary
CCR is responsible for post - service claim review to determine if specific
services can be reimbursed to providers and members.
- The analyst role is integral to the CCR team.
-They start the CCR process with the claim submission to CCR with a complete
review of the claim and claim history. They compile all system information,
claim history, plan information, and any additional research into template as
required by the workflow and any legal and regulatory requirements for a
clinician review.
-They also collaborate with Medical Directors as required.
-Review provider and member claims to determine if they meet CCR review requirements.
-Follow applicable workflows, templates, and legal and compliance
requirements to provide a complete picture of what is requiring review to the CCR clinicians and medical directors.
-Organizes and prioritizes work to help meet regulatory and CCR claim turnaround times. Determines coverage, verifies eligibility, benefits, identifies discrepancies and applies all Medical Claim Management policies and procedures to assist in ensuring claims are handled per policy and legal requirements.
-Works with all appropriate internal and external departments and personnel to accurately review specified claims and/or clarify any issues found in the course of the review.
-Required to work in multiple systems including EWM, ASD, ATV, MedCompass and HRP.
-Other systems dependent on specific reviews criteria.
-Maintains and utilizes all resource materials and systems to effectively manage job responsibilities
Adheres to company policies to protect member
confidentiality.
Required Qualifications
2+ years experience and demonstrated ability to handle multiple assignments competently, accurately and efficiently.
Preferred Qualifications
Knowledge of utilization management rules and regulations and claim processing guidelines.
Claims Processing/ customer service experience preferred


Education Verifiable High School Diploma or GED.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $38.82

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/25/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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