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Work From Home Medical Claims Processing Jobs in Reston, VA

C-MCI

Medical Billing Specialist

Fairfax, VA · On-site +1

$18.50 - $24/hr

... processing, revenue cycle management, and contribute valuable insights to develop AI-powered tools ... Work withclearinghouses and insurance payers to track claims and resolve denials,rejections, and ...

The Jernigan Agency

WORK FROM HOME

Washington, DC · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales ... See the application through the underwriting process and get our clients covered. Requirements for ...

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All JobsMedical Claims Processing JobsWork From Home Medical Claims Processing JobsWork From Home Medical Claims Processing Jobs in Reston, VA

Work From Home Medical Claims Processing information

See Reston, VA salary details

$14

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$26

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

As of Aug 8, 2026, the average hourly pay for work from home medical claims processing in Reston, VA is $20.25, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $22.50 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.

What are popular job titles related to Work From Home Medical Claims Processing jobs in Reston, VA? For Work From Home Medical Claims Processing jobs in Reston, VA, the most frequently searched job titles are:
What job categories do people searching Work From Home Medical Claims Processing jobs in Reston, VA look for? The top searched job categories for Work From Home Medical Claims Processing jobs in Reston, VA are:
What cities near Reston, VA are hiring for Work From Home Medical Claims Processing jobs? Cities near Reston, VA with the most Work From Home Medical Claims Processing job openings:
Work From Home Medical Claims Processing jobs near you
Infographic showing various Work From Home Medical Claims Processing job openings in Reston, VA as of July 2026, with employment types broken down into 88% Full Time, 9% Part Time, and 3% Contract. Highlights an 88% Physical, 4% Hybrid, and 8% Remote job distribution, with an average salary of $42,127 per year, or $20.3 per hour.

Medical Billing Specialist

C-MCI

Fairfax, VA • On-site, Remote

$18.50 - $24/hr

Full-time

Re-posted 5 days ago

Job description


Position: Medical Billing Specialist
Location: Remote / On-site
Department: Revenue Cycle Management
Overview:
CMCI is seeking a detail-oriented and experienced Medical Billing Specialist to oversee claims processing, revenue cycle management, and contribute valuable insights to develop AI-powered tools that enhance medical billing workflows. The ideal candidate will have expertise in medical coding, claims submission, payer interactions, and denial management, ensuring optimized billing practices for maximum reimbursement and minimal claim rejections.
Why Join CMCI?
  • Opportunityto work with cutting-edge AI-driven billing solutions that optimizeRCM efficiency.
  • Work in acollaborative environment with healthcare and AI professionals.
  • Competitivesalary, benefits, and professional development opportunities.

Key Responsibilities:
  • ClaimsProcessing & Submission:
    • Accuratelyprocess, review, and submit medical claims.
    • Verify CPT,ICD-10, and HCPCS codes to ensure claims compliance withpayer-specific policies.
    • Work withclearinghouses and insurance payers to track claims and resolve denials,rejections, and underpayments efficiently.
  • Revenue CycleManagement (RCM):
    • Oversee theentire claims lifecycle, from eligibility verification to final paymentreconciliation.
    • Monitoraccounts receivable (A/R) aging reports and ensure timely follow-upon outstanding claims.
    • Optimizepayer reimbursement rates by leveraging contractual agreements andcoding best practices.
  • Payer &Compliance Coordination:
    • Utilize thepayer lookup database to retrieve Payer IDs and transactiontypes for accurate claim submission.
    • Ensurecompliance with Medicare, Medicaid, and private insuranceguidelines to prevent fraud and billing errors.
    • Stay updatedon coding changes, regulatory requirements, and payer policies tomaintain accuracy in claims processing.
  • Technology& AI Development Support:
    • Provideinsights into billing workflows, common claim errors, and automationopportunities to improve AI-driven billing tools.
    • Assist intesting and refining AI-powered RCM solutions, including automated claimsscrubbing and predictive denial management.
    • Collaboratewith the engineering and data science teams to train AI models forenhanced claims accuracy.

Requirements
Required Qualifications:
  • Education& Certification:
    • Associate'sor Bachelor's degree in Health Information Management, Business, or arelated field (preferred).
    • CertifiedProfessional Biller (CPB) or Certified Professional Coder(CPC) (preferred).
  • Experience:
    • 2+ years ofexperience in medical billing, claims processing, or revenue cyclemanagement.
    • Strongknowledge of CPT, ICD-10, and HCPCS coding systems.
    • Experienceworking with Medicare, Medicaid, and commercial insurance payers.
  • TechnicalSkills:
    • Proficiencywith billing and practice management software such as:
      • ElectronicHealth Records Systems: Epic, Cerner, Athenahealth
      • Clearinghouseplatforms: Emdeon, Availity, Change Healthcare, Waystar, Kareo
    • Experiencewith ANSI X12 837 EDI claims processing.
    • Strong Exceland data analysis skills for tracking claim performance.
    • Familiaritywith AI-based RCM tools is a plus.
  • Soft Skills:
    • Stronganalytical and problem-solving skills for identifying claimdiscrepancies.
    • Excellentcommunication and collaboration skills to liaise with providers andpayers.
    • Ability towork independently and in a team environment in a fast-pacedsetting.

Join CMCI to help revolutionize the future of AI-powered medical billing!
All qualified applicants will receive consideration for employment without regard to any characteristic protected by local, state, or federal laws, rules, or regulations

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