Process refunds and recover overpayments from providers or members. Communicate with providers ... Preferred Knowledge Medical claims adjudication Coordination of Benefits (COB) Medicare primacy ...
Process refunds and recover overpayments from providers or members. Communicate with providers ... Preferred Knowledge Medical claims adjudication Coordination of Benefits (COB) Medicare primacy ...
Medical Claims Processor
$17 - $18/hr
Entry to mid-level Location : Work at Home Pay Rate: 17.00-18.00 In this Role the candidate will be ... Processing of Professional and Hospital claim forms files by provider * Reviewing the policies and ...
Medical Claims Processor
$17 - $18/hr
Entry to mid-level Location : Work at Home Pay Rate: 17.00-18.00 In this Role the candidate will be ... Processing of Professional and Hospital claim forms files by provider * Reviewing the policies and ...
Medical Claims COB Processor I
Milwaukie, OR · Remote
$18.39 - $20.58/hr
... for claims processing. Assists in customer service inquiries regarding contractual and ... This is a FT WFH role. Pay Range $18.39 - $20.58 hourly, DOE. *Actual pay is based on ...
Medical Claims COB Processor I
Milwaukie, OR · Remote
$18.39 - $20.58/hr
... for claims processing. Assists in customer service inquiries regarding contractual and ... This is a FT WFH role. Pay Range $18.39 - $20.58 hourly, DOE. *Actual pay is based on ...
... in processing complex medical claims. If you are eager to make a positive impact in the community through your administrative skills, we encourage you to apply. Work Schedule * Remote * Monday ...
... in processing complex medical claims. If you are eager to make a positive impact in the community through your administrative skills, we encourage you to apply. Work Schedule * Remote * Monday ...
Claims Reviewer
Phoenix, AZ · Remote
$25 - $29/hr
Conducts medical claims review using current claims processing guidelines and established clinical criteria e.g. CDST and policy keys, to evaluate medical necessity, appropriateness of care and ...
Quick apply
Claims Reviewer
Phoenix, AZ · Remote
$25 - $29/hr
Conducts medical claims review using current claims processing guidelines and established clinical criteria e.g. CDST and policy keys, to evaluate medical necessity, appropriateness of care and ...
Medical Claims Processor
$17 - $18/hr
... processing of professional and hospital claim forms files by provider. Reviewing the policies and ... Work independently to research, review and act on the claims. Prioritize work and adjudicate claims ...
Medical Claims Processor
$17 - $18/hr
... processing of professional and hospital claim forms files by provider. Reviewing the policies and ... Work independently to research, review and act on the claims. Prioritize work and adjudicate claims ...
Claims Reviewer
Phoenix, AZ · Remote
$26.40 - $27.88/hr
... claims processing. If you have a strong foundation in medical claims and are passionate about ... Work closely with medical directors, providers, peer reviewers, and various internal teams. Key ...
Quick apply
Claims Reviewer
Phoenix, AZ · Remote
$26.40 - $27.88/hr
... claims processing. If you have a strong foundation in medical claims and are passionate about ... Work closely with medical directors, providers, peer reviewers, and various internal teams. Key ...
Claims Examiner I
Fresno, CA · On-site +1
$40K - $52K/yr
... work-from-home, in-office or hybrid options. With competitive compensation packages, premier ... Claims Examiner I is responsible for reviewing and processing medical, dental, vision, and ...
Claims Examiner I
Fresno, CA · On-site +1
$40K - $52K/yr
... work-from-home, in-office or hybrid options. With competitive compensation packages, premier ... Claims Examiner I is responsible for reviewing and processing medical, dental, vision, and ...
Claims Processor (52219)
Oklahoma City, OK · Remote
$15.75 - $20/hr
Two year of medical claims processing experience strongly preferred. KNOWLEDGE, SKILLS AND ... WORK ENVIRONMENT: * Current work environment is remote, however, some state exclusions apply. Must ...
Claims Processor (52219)
Oklahoma City, OK · Remote
$15.75 - $20/hr
Two year of medical claims processing experience strongly preferred. KNOWLEDGE, SKILLS AND ... WORK ENVIRONMENT: * Current work environment is remote, however, some state exclusions apply. Must ...
Claims Processor (52219)
$17.50 - $22/hr
Two years of medical claims processing experience strongly preferred. Knowledge, Skills and ... Work Environment: * Current work environment is remote, however, some state exclusions apply.
Claims Processor (52219)
$17.50 - $22/hr
Two years of medical claims processing experience strongly preferred. Knowledge, Skills and ... Work Environment: * Current work environment is remote, however, some state exclusions apply.
Medical Claims Examiner
Los Angeles, CA · On-site +1
$24 - $30/hr
General information Client / Corporate Client Work Mode Hybrid Name Medical Claims Examiner Job ID ... Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.
Medical Claims Examiner
Los Angeles, CA · On-site +1
$24 - $30/hr
General information Client / Corporate Client Work Mode Hybrid Name Medical Claims Examiner Job ID ... Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.
Be Seen First
$19/Hr. Remote Medical Claims Rep.
Las Vegas, NV · Remote
$19/hr
M-Fri. (Must be able to work ANY 8hr Shift between these hours) * Job Type: TTH * Projected Start Date: Early TBA Key Responsibilities: * Review and process medical claims submitted by healthcare ...
New
Quick apply
Be Seen First
$19/Hr. Remote Medical Claims Rep.
Las Vegas, NV · Remote
$19/hr
M-Fri. (Must be able to work ANY 8hr Shift between these hours) * Job Type: TTH * Projected Start Date: Early TBA Key Responsibilities: * Review and process medical claims submitted by healthcare ...
New
Claims Processor (52219)
Oklahoma City, OK · Remote
$15.75 - $20/hr
Two year of medical claims processing experience strongly preferred. KNOWLEDGE, SKILLS AND ... WORK ENVIRONMENT: * Current work environment is remote, however, some state exclusions apply. Must ...
Claims Processor (52219)
Oklahoma City, OK · Remote
$15.75 - $20/hr
Two year of medical claims processing experience strongly preferred. KNOWLEDGE, SKILLS AND ... WORK ENVIRONMENT: * Current work environment is remote, however, some state exclusions apply. Must ...
Claims Processor (52219)
Oklahoma City, OK · On-site +1
$15.75 - $20/hr
Two year of medical claims processing experience strongly preferred. KNOWLEDGE, SKILLS AND ... WORK ENVIRONMENT: * Current work environment is remote, however, some state exclusions apply. Must ...
Claims Processor (52219)
Oklahoma City, OK · On-site +1
$15.75 - $20/hr
Two year of medical claims processing experience strongly preferred. KNOWLEDGE, SKILLS AND ... WORK ENVIRONMENT: * Current work environment is remote, however, some state exclusions apply. Must ...
Claims Process Documentation & Training Specialist
Buffalo, NY · Remote
$75K - $80K/yr
... medical claims processing and adjudication. * 3 years demonstrated experience writing clear ... An ideal candidate would be assigned to the Buffalo Office with ability to work from home Centivo ...
Quick apply
Claims Process Documentation & Training Specialist
Buffalo, NY · Remote
$75K - $80K/yr
... medical claims processing and adjudication. * 3 years demonstrated experience writing clear ... An ideal candidate would be assigned to the Buffalo Office with ability to work from home Centivo ...
Claims Processor (52219)
Oklahoma City, OK · On-site +1
$15.75 - $20/hr
Two year of medical claims processing experience strongly preferred. KNOWLEDGE, SKILLS AND ... WORK ENVIRONMENT: * Current work environment is remote, however, some state exclusions apply. Must ...
Claims Processor (52219)
Oklahoma City, OK · On-site +1
$15.75 - $20/hr
Two year of medical claims processing experience strongly preferred. KNOWLEDGE, SKILLS AND ... WORK ENVIRONMENT: * Current work environment is remote, however, some state exclusions apply. Must ...
$20 - $25/hr
Minimum of 5 years' experience in medical claims processing, including professional and facility ... Capacity to work independently as well as collaboratively within a team. * Commitment to ongoing ...
$20 - $25/hr
Minimum of 5 years' experience in medical claims processing, including professional and facility ... Capacity to work independently as well as collaboratively within a team. * Commitment to ongoing ...
$22 - $25/hr
Minimum of 5 years' experience in medical claims processing, including professional and facility ... Capacity to work independently as well as collaboratively within a team. * Commitment to ongoing ...
$22 - $25/hr
Minimum of 5 years' experience in medical claims processing, including professional and facility ... Capacity to work independently as well as collaboratively within a team. * Commitment to ongoing ...
Medical Claims Examiner
CA · On-site +1
$24 - $30/hr
Well-being and work-life balance: Paid time off, flexible schedule, and remote work choices ... Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.
Medical Claims Examiner
CA · On-site +1
$24 - $30/hr
Well-being and work-life balance: Paid time off, flexible schedule, and remote work choices ... Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.
Claims Examiner - Remote
Tampa, FL · Remote
... processing medical claims and provider dispute requests in accordance with payer guidelines ... Ability to work independently or within a team * Time management skills * Written and verbal ...
Claims Examiner - Remote
Tampa, FL · Remote
... processing medical claims and provider dispute requests in accordance with payer guidelines ... Ability to work independently or within a team * Time management skills * Written and verbal ...
Work From Home Medical Claims Processing information
See salary details
$13.94 - $15.01
6% of jobs
$15.01 - $16.08
6% of jobs
$16.08 - $17.15
11% of jobs
$17.27 is the 25th percentile. Wages below this are outliers.
$17.15 - $18.23
15% of jobs
The median wage is $19.01 / hr.
$18.23 - $19.30
16% of jobs
$19.30 - $20.37
11% of jobs
$21.38 is the 75th percentile. Wages above this are outliers.
$20.37 - $21.44
11% of jobs
$21.44 - $22.51
11% of jobs
$22.51 - $23.58
6% of jobs
$23.58 - $24.65
5% of jobs
$24.65 - $25.72
2% of jobs
$13
$19
$25
How much do work from home medical claims processing jobs pay per hour?
As of Aug 6, 2026, the average hourly pay for work from home medical claims processing 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 work from home medical claims processing?
A Work From Home Medical Claims Processing job involves reviewing, verifying, and processing medical insurance claims from a remote location. Responsibilities typically include checking claims for accuracy, ensuring compliance with insurance policies, and submitting claims for reimbursement. This role requires knowledge of medical coding, billing procedures, and insurance guidelines. Strong attention to detail and proficiency with billing software are essential for success in this position. Many employers prefer candidates with prior experience or relevant certifications in medical billing and coding.
What are some common challenges faced in work from home medical claims processing, and how can they be managed?
One common challenge in a remote medical claims processing position is maintaining clear communication and collaboration with colleagues and supervisors, since the team operates virtually. Staying organized and self-motivated is essential, as you'll need to manage a steady volume of claims independently and meet strict deadlines. To overcome these challenges, many employers provide regular virtual check-ins, ongoing training, and access to online support tools, making it easier to ask questions and share updates. By proactively reaching out when clarification is needed and effectively utilizing provided resources, remote claims processors can remain connected and productive.
What are the key skills and qualifications needed to thrive in work from home medical claims processing?
To excel in Work From Home Medical Claims Processing, strong attention to detail, knowledge of medical terminology and billing codes, and prior experience in claims or healthcare administration are typically required. Familiarity with claims processing software (such as Facets, Epic, or Medisoft) and knowledge of HIPAA compliance are highly valuable, and certification such as Certified Professional Coder (CPC) can be an advantage. Excellent organizational skills, time management, and effective written communication help professionals handle caseloads efficiently and collaborate remotely. These skills and qualities are vital for ensuring accuracy, compliance, and timely processing of claims in a fast-paced, virtual environment.
More about Work From Home Medical Claims Processing jobs
What cities are hiring for Work From Home Medical Claims Processing jobs? Cities with the most Work From Home Medical Claims Processing job openings:
What states have the most Work From Home Medical Claims Processing jobs? States with the most job openings for Work From Home Medical Claims Processing jobs include:
What job categories do people searching Work From Home Medical Claims Processing jobs look for? The top searched job categories for Work From Home Medical Claims Processing jobs are:
- Biberk
- Salaried Biberk
- Workers Compensation Claims Adjuster Trainee
- Workers Compensation Subrogation Specialist
- Worker Compensation Claims Adjuster
- Entry Level Workers' Compensation Claims Adjuster
- Temporary 1099 Claims Adjuster
- Workers Comp Adjuster Salary
- Remote Aaa Claims Adjuster
- Workers Compensation Claims Adjuster
Claims Specialist II (Medical Claims / Coordination of Benefits)
Baton Rouge, LA • Remote
$19/hr
Other
Medical
Posted 5 days ago
Job description
Job Description Claims Specialist II (Medical Claims / Coordination of Benefits) Location: Remote (Louisiana Preferred) Contract Length: 5 Months Pay Rate: Up to $19/hour (W2) Industry: Health Insurance / Medical Claims Position Summary We are seeking an experienced Claims Specialist II with medical claims processing experience to support a high-volume health insurance claims operation. This position is responsible for processing and adjusting medical claims, researching claim issues, determining Coordination of Benefits (COB), recovering overpayments, and ensuring claims are processed accurately while maintaining compliance with HIPAA and company policies. Louisiana candidates are preferred.
This is a remote opportunity. Required Qualifications High School Diploma or equivalent Minimum 2 years of medical claims processing experience Claims processing experience is required Coordination of Benefits (COB) experience strongly preferred Experience determining primary vs. secondary insurance coverage Knowledge of medical claims adjudication and claims edits Strong analytical, problem-solving, and investigative skills Excellent verbal and written communication skills Working knowledge of Microsoft Office and claims processing systems Ability to prioritize multiple workstreams in a fast-paced environment Preferred Experience Hands-on Coordination of Benefits (COB) processing Medicare coordination and primacy determination Provider reimbursement and overpayment recovery Health insurance or managed care environment Key Responsibilities Process medical claims, claims edits, and claims adjustments accurately.
Research and determine the correct Coordination of Benefits (COB) for members with multiple insurance plans. Identify primary and secondary coverage using subscriber status, plan type, Medicare coordination, and effective dates. Review and update claims to ensure proper payment and reimbursement.
Investigate and resolve complex claims issues and discrepancies. Process refunds and recover overpayments from providers or members. Communicate with providers, members, Medicare, and other insurance carriers regarding claim status and coverage.
Maintain accurate claims records while ensuring compliance with HIPAA and regulatory requirements. Review quality audits and complete corrections within departmental guidelines. Support special projects, training initiatives, and departmental process improvements.
Preferred Knowledge Medical claims adjudication Coordination of Benefits (COB) Medicare primacy rules Provider reimbursement Claims adjustments and overpayment recovery HIPAA compliance Medical terminology Health insurance operations Ideal Background Candidates with experience in organizations such as: Blue Cross Blue Shield UnitedHealthcare / Optum Humana Elevance Health (Anthem) Aetna / CVS Health Cigna Centene Molina Healthcare Kaiser Permanente Highmark GuideWell / Florida Blue CareFirst HealthPartners AmeriHealth This opportunity is ideal for candidates with strong medical claims processing and Coordination of Benefits (COB) experience who thrive in a detail-oriented, production-focused healthcare environment.
About Strategystaff
Sourced by ZipRecruiter
Company size
201 - 500 Employees
Headquarters location
Sparta, NJ, US
Year founded
2008