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Work From Home Medical Claims Processor Jobs (NOW HIRING)

NTT DATA

Healthcare Claims Processor, Remote

$17.50 - $22/hr

Remote Claims Processing Associate NTT DATA is seeking to hire a Remote Claims Processing Associate ... Previously performing - in P&Q work environment; work from queue; remotely * Key board skills and ...

Moda Health

Supervisor, Medical Claims

Milwaukie, OR · Remote

$59K - $74K/yr

... from candidates that share our commitment to this diversity. Our diverse experiences and ... College degree or equivalent work experience. * 2 - 4 years medical claims processing experience ...

Western Growers

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 ...

Amerita

Pharmacy Claims Processor / Remote

Louisville, KY · On-site +1

$15.50 - $19.75/hr

This position is 100% remote, giving you the freedom to work from anywhere! What You'll Do: As a ... claims, billing and insurance processing. Pharmacy Technician experience and/or knowledge of ...

Aon

Claims Processor - Flex Benefits

$43K - $50K/yr

Claims Processor NFP, an Aon company, and American Benefits Group (ABG) are organizations of ... Work well under stressful situations and handle a large client book with high call and email ...

Conduent, Inc.

Remote Claims Processor

VA · Remote

$15/hr

Ability to work independently in a remote setting * Adaptable and able to shift priorities quickly ... As a result, we may be unable to consider applicants from certain states or municipalities at this ...

Trident

Medical Claims Examiner

$30/hr

Review, analyze, and process complex self-funded medical claims from start to finish. * Utilize the ... Ability to work independently as a 1099 contractor, managing your own remote office setup and ...

Moda Health

Dental Claims Processor I

Milwaukie, OR · Remote

$17.34 - $18.36/hr

... from candidates that share our commitment to this diversity. Our diverse experiences and ... Medical, Dental, Vision, Pharmacy, Life, & Disability * 401K- Matching * FSA * Employee Assistance ...

NFP Corp

Claims Processor - Flex Benefits

Agawam, MA · On-site +1

$43K - $50K/yr

NFP, an Aon company, is a multiple Best Places to Work award winner in Business Insurance. We are ... The Claims Processor is responsible for accurate and timely processing of claims which includes ...

NFP Corp

Claims Processor - Flex Benefits

Agawam, MA · Remote

$43K - $50K/yr

NFP, an Aon company, is a multiple Best Places to Work award winner in Business Insurance. We are ... The Claims Processor is responsible for accurate and timely processing of claims which includes ...

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Work From Home Medical Claims Processor information

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

As of Aug 16, 2026, the average hourly pay for work from home medical claims processor 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 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.

What cities are hiring for Work From Home Medical Claims Processor jobs?

Cities with the most Work From Home Medical Claims Processor job openings:

What states have the most Work From Home Medical Claims Processor jobs?

States with the most job openings for Work From Home Medical Claims Processor jobs include:

Work From Home Medical Claims Processor jobs near you
Infographic showing various Work From Home Medical Claims Processor job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $40,493 per year, or $19.5 per hour.

Pharmacy Claims Processor / Remote

BrightSpring

Louisville, KY • Remote

$15.50 - $19.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 hours ago

Job description

Our Company
PharMerica
Overview
Step Into a Rewarding Role as an LTC Pharmacy Claims Specialist with PharMerica!
Are you ready to make a real impact in a growing organization? Join our PharMerica team as a Claims Specialist, where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical support they need. We offer a non-retail, closed-door pharmacy environment, allowing you to focus on what truly matters-delivering exceptional care and service.
Why Join PharMerica?
  • Focused on Service Excellence: Our mission is to provide top-quality care and outstanding customer service to hospitals, rehabilitation centers, long-term acute care hospitals, and specialized care centers across the nation.
  • Career Growth: We're in high growth mode, offering plenty of opportunities for those looking to advance their careers.
  • Remote Flexibility: This position is 100% remote, giving you the freedom to work from anywhere!

What You'll Do: As a dynamic Claims Specialist, you will:
  • Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need.
  • Be a vital part of a team that's dedicated to enhancing patient care through meticulous claims management and customer service.
Shift: Varying shifts available from 4:30am-12:00am. Overnight & Weekend shifts required.
Must have pharmacy claims or adjudication background.
What We Offer:
  • DailyPay
  • Flexible Schedules
  • Competitive Pay with Shift Differentials
  • Health, Dental, Vision, and Life Insurance
  • Company-Paid Disability Insurance
  • Tuition Assistance & Reimbursement
  • Employee Discount Program
  • 401k Plan
  • Paid Time Off
  • Non-Retail, Closed-Door Environment

Responsibilities
The Claims Specialist - 3rd Party:
  • Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks
  • Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines
  • Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement
  • Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes
  • Works as a team to identify, document, communicate and resolve payer/billing trends and issues
  • Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans
  • Prepares and maintains reports and records for processing
  • Performs other tasks as assigned

Qualifications
Education/Learning Experience:
  • Required: High School Diploma or GED
  • Desired: Associate's or Bachelor's Degree
Work Experience:
  • Required: Customer Service
  • Desired: Up to one year of related experience. Pharmacy Technician experience
Skills/Knowledge:
  • Required: Ability to retain a large amount of information and apply that knowledge to related situations. Ability to work in a fast-paced environment. Basic math aptitude. Microsoft Office Suite
  • Desired: Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsetters
Licenses/Certifications:
  • Desired: Pharmacy technician, but not required

About our Line of Business
PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.
Additional Job Information
This is an excellent opportunity to move from a retail to office environment for those who are willing to learn claims, billing and insurance processing.
Pharmacy Technician experience and/or knowledge of pharmaceuticals is a strong preference.