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Work From Home Medical Claims Processor Jobs in Raleigh, NC

HMG Careers

Work From Home Sales Specialist

Kenly, NC · Remote

$69K/yr

What We Offer * Remote, work-from-home career * Average first-year earnings of $69K through ... Comprehensive benefits package including medical, dental, and prescription coverage * Ongoing ...

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Work From Home Medical Claims Processor information

See Raleigh, NC salary details

$13

$18

$25

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

As of Jul 27, 2026, the average hourly pay for work from home medical claims processor in Raleigh, NC is $18.92, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $21.01 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Work From Home Medical Claims Processor, and why are they important?

To thrive as a Work From Home Medical Claims Processor, you need a solid understanding of medical terminology, insurance policies, and claims procedures, often supported by a high school diploma or specialized certification. Familiarity with claims management software, electronic health record (EHR) systems, and billing codes like ICD-10 and CPT is typically required. Strong attention to detail, time management, and effective written communication are critical soft skills for this remote role. These skills ensure claims are processed accurately and efficiently, reducing errors and supporting timely reimbursement for healthcare providers.

What does a Work From Home Medical Claims Processor do?

A Work From Home Medical Claims Processor reviews, processes, and evaluates medical insurance claims submitted by healthcare providers and patients. They verify the accuracy of the information, ensure compliance with insurance policies, and determine the appropriate payment or denial of claims. This role requires attention to detail, knowledge of medical terminology and coding, and the ability to work independently using secure computer systems from a remote location.

What is the difference between Work From Home Medical Claims Processor vs Medical Billing Specialist?

AspectWork From Home Medical Claims ProcessorMedical Billing Specialist
CredentialsBasic medical claims processing certification, high school diplomaMedical billing certification, high school diploma or equivalent
Work EnvironmentRemote, home-basedRemote or office-based
Industry UsageInsurance companies, third-party administratorsHealthcare providers, clinics, hospitals
Job FocusReviewing and processing insurance claims for reimbursementCreating and managing patient invoices and billing records

While both roles involve working with healthcare financial data, a Work From Home Medical Claims Processor primarily reviews and processes insurance claims remotely, focusing on reimbursement. In contrast, a Medical Billing Specialist handles patient billing and invoicing, which may include creating bills and managing accounts. Both roles often require similar certifications and can be performed remotely, but they serve different functions within the healthcare revenue cycle.

What are some common challenges faced by Work From Home Medical Claims Processors, and how can they be managed?

Work From Home Medical Claims Processors often face challenges such as staying organized with a high volume of electronic claims, maintaining accuracy amidst complex medical codes, and communicating effectively with colleagues or clients remotely. To manage these challenges, it's important to establish a structured daily routine, utilize reliable claim management software, and participate in regular virtual team meetings. Additionally, continuous learning about updates in medical billing and insurance policies can help processors stay efficient and reduce errors.
Work From Home Medical Claims Processor jobs near you
Infographic showing various Work From Home Medical Claims Processor job openings in Raleigh, NC as of July 2026, with employment types broken down into 75% Full Time, 8% Part Time, and 17% Contract. Highlights an 8% In-person, and 92% Remote job distribution, with an average salary of $39,362 per year, or $18.9 per hour.

Claims Processor Self-Funded

Marpai Administrators LLC

Cary, NC • Remote

$24 - $30/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 29 days ago

Job description

Marpai Administrators is a technology company transforming the Third-Party Administration sector serving employers with self-funded health plans. Marpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. We create healthier members and a healthier bottom line. Marpai proactively targets at-risk members with meaningful clinical interventions to improve outcomes. 
ABOUT THE POSITION:
The Claims Processor will be responsible to for reviewing claims for accuracy, completeness, and eligibility. The Claims Processor is responsible to adjudicate claims, complete work assignments and meet established departmental metrics.  
WHAT YOU WILL BE DOING: 
  • Data entry of claims into system. 
  • Review, analyze adjudicate claims 
  • Validate the information on all claims to ensure there is no missing or incomplete information
  • Ability to understand and apply benefits as outlined in plan document
  • Maintain/manage all claim inventories in accordance with health plan and regulatory policies
  • Display maturity, composure and ability to operate under stressful conditions.
  • Complete daily assignments and update required spreadsheet
  • Complete end of day summary
  • Flexibility to change work direction as determined by management
  • Meet departmental standards for quality, production and attendance. 
  • Analyst is flexible and able to commit to overtime based on business needs 
  • Other duties as required
 
WHAT DO YOU NEED 
  • Associates degree preferred
  • 2+ yrs claims processing self-funded claims
  • Strong analytical, research, and communication skills.
  • Expansive knowledge of medical terminology.
  • Excellent verbal and written communication skills as well as exemplary organizational skills.
  • Work closely with leadership to assist in mitigating trends as necessary.
  • Independent judgment in decision-making and problem solving.
  • Computer skills in MS Word, Excel, PowerPoint, & Outlook at the intermediate or higher level.
  • Ability to multi-task & anticipate potential needs/problems.
  • Strong attention to detail.
  • Ability to understand and apply on-line documentation policies and procedures.
  • Excellent customer services skills including an ability to follow through, take ownership and drive all assigned tasks to completion.
  • Ability to handle large volumes of work, solve problems and manage multiple assignments while meeting critical deadlines.
  • HIPAA Compliance
 
WORK REQUIREMENTS:
  • Fast paced, dynamic work environment requiring the ability to be adaptive, innovative and flexible
  • Travel minimal
 
WHY WORK AT MARPAI?  
We have great benefits: 
  • Generous PTO
  • Medical and Prescription 
  • EAP 
  • FSA / HSA / Dependent Care
  • Dental 
  • Vision 
  • Life and Disability 
  • STD/LTD
  • Voluntary Benefits: Critical Illness, Accident, Hospital
  • 401k with Employer Match
  • LegalShield
  • Identity Theft Protection
 
Marpai is an equal opportunity workplace.  We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.

This is a remote position.