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Sarah Jenkins
Remote Claims Examiner jobs in the United States
Job type
Min. salary, $/year
Level
Insurance companies throughout the USA are expanding their teams, creating steady demand for claims examiner remote jobs. With 500+ open positions currently available, this is an ideal time for detail-oriented professionals to join a growing field that values accuracy and sound judgment. The shift toward remote work has made these opportunities accessible to candidates nationwide.
Success in this field depends on strong analytical thinking, careful attention to detail, and a thorough understanding of policy language and regulatory requirements. Professionals must communicate clearly with policyholders, adjusters, and legal representatives while evaluating evidence and documentation to reach fair outcomes. Proficiency with claims management systems and the ability to stay organized under tight deadlines are also highly valued by employers looking to hire a claims examiner.
Remote work in this profession typically involves reviewing files, verifying information, and coordinating with insurers through secure digital platforms, all without the need for a physical office. Many companies across the USA now offer flexible, home-based arrangements, reflecting a broader hiring outlook for claims examiner vacancies in nearly every state. This trend has made it easier for qualified professionals to find rewarding positions regardless of where they live.
If you're ready to take the next step in your career, now is a great moment to explore new claims examiner positions. Global Work AI connects talented professionals with employers offering remote roles nationwide, making it simple to find the right opportunity and move forward with confidence.
Allied Benefit Systems
Review and analyze medical claims for cost reasonableness, medical necessity, and fraud. Determine benefit levels and negotiate discounts with providers. Process claims in the QicLink System, document findings, and create summary reports.
remote, IL, United States$50k/yrFull TimeSenior (5+ years)
Tristar Insurance
Review and interpret policy coverage for automobile physical damage and property damage liability claims. Conduct thorough investigations, evaluate claims, negotiate settlements, and prepare comprehensive loss reports.
remote, United States$72k – $80k/yrFull TimeJunior (<2 years)Tristar Insurance
Review and interpret policy coverage for automobile physical damage and property damage liability claims. Conduct thorough investigations, evaluate claims, negotiate settlements, and prepare comprehensive loss reports.
remote, United States$72k – $80k/yrFull TimeJunior (<2 years)
Gallagher
Manage Workers' Compensation indemnity claims, oversee complex claim issues, and ensure timely reporting to stakeholders. Prepare for file reviews, negotiate settlements, resolve liens, and monitor defense attorneys.
remote, CA, United States$75k – $105k/yrFull TimeSenior (5+ years)
Resolution Life
Examine and investigate disability, life, and annuity claims, ensuring accurate and timely service. Prepare correspondence, monitor claims through the workflow system, and maintain records and databases.
remote, IA, United States$40k – $55k/yrFull TimeEntry with Degree
Network180 - Kent County Community Mental Health
Process, adjust, and pay claims submitted by Network180’s provider network. Analyze information and prepare spreadsheets and reports. Ensure accurate claims processing in compliance with Medicaid, Medicare, and third-party insurance regulations. Manage tasks efficiently within a 40-hour work week.
remote, MI, United States$44k – $59k/yrFull TimeMiddle (2-4 years)
Sedgwick
Analyze and process Medical Only & Lost-Time Workers Compensation claims, ensuring timely resolution through investigation and information gathering. Negotiate settlements within designated authority and communicate claim activity with claimants and clients.
remote, MA, United States$80k – $85k/yrFull TimeJunior (<2 years)
Transamerica
Analyze claim documentation to determine payment or denial based on policy provisions and regulations. Review claims and gather additional information from various sources. Document communications and correspond with claimants and medical providers.
remote, United States$42k – $48k/yrFull TimeMiddle (2-4 years)
The Baldwin Group
Manage third-party bodily injury and property damage claims from initial assignment to resolution, including negotiating settlements. Evaluate insurance policies for coverage determinations, draft Reservation of Rights letters, and conduct thorough investigations.
remote, United StatesFull TimeLead / Manager
MSI, part of The Baldwin Group
Manage third-party bodily injury and property damage claims from initial assignment to resolution, including negotiating settlements. Evaluate insurance policies for coverage determinations, draft Reservation of Rights letters, and conduct thorough investigations.
remote, United StatesFull TimeLead / ManagerSedgwick
Analyze and process Workers Compensation claims, ensuring timely resolution through investigation and information gathering. Negotiate settlements within designated authority and communicate claim activity with claimants and clients.
remote, CT, United States$75k – $80k/yrFull TimeMiddle (2-4 years)
Athens Administrators
Adjust workers’ compensation claims from inception through settlement and closure, ensuring timely processing and payment of benefits. Manage medical treatment, set reserves, negotiate settlements, and prepare reports for clients.
remote, CA, United StatesFull TimeSenior (5+ years)
NTT DATA Services
Process professional claim forms by providers, review policies and benefits, and ensure compliance with HIPAA regulations. Research and adjudicate claims independently while meeting turnaround times and quality targets.
remote, Plano, TX, United StatesFull TimeMiddle (2-4 years)Sedgwick
Analyze and process Workers Compensation claims to determine benefits due, ensuring timely resolution through investigation and information gathering. Negotiate settlements within designated authority and communicate claim activity with claimants and clients.
remote, NC, United StatesFull TimeSenior (5+ years)Sedgwick
Analyze and process workers compensation claims to determine benefits due, ensuring timely resolution through investigation and information gathering. Negotiate settlements within designated authority and communicate claim activity with claimants and clients.
remote, CA, United States$85k – $105k/yrFull TimeMiddle (2-4 years)Gallagher
Manage Workers' Compensation indemnity claims, overseeing complex claim issues and ensuring compliance with regulatory requirements. Prepare and attend file reviews, negotiate settlements, and monitor defense attorneys.
remote, CA, United States$75k – $105k/yrFull TimeSenior (5+ years)Athens Administrators
Adjust workers’ compensation claims from inception through settlement and closure, ensuring timely processing and payment of benefits. Manage medical treatment, set reserves, negotiate settlements, and prepare reports for clients.
remote, CA, United StatesFull TimeSenior (5+ years)
Raphael and Associates
Negotiate and settle vehicular total loss claims, evaluate vehicle damage, and determine actual cash value (ACV). Manage salvage valuations, coordinate vehicle transfers, and oversee wreckage disposal.
remote, United StatesFull TimeMiddle (2-4 years)Sedgwick
Adjudicate complex general liability claims, develop claim and defense strategies, and identify settlement opportunities. Handle high-end cases involving serious injuries and complex coverage scenarios.
remote, CA, United States$90k – $115k/yrFull TimeSenior (5+ years)Sedgwick
Analyze and process Lost-Time Workers Compensation claims, ensuring timely resolution through investigation and information gathering. Negotiate settlements within designated authority and communicate claim activity with claimants and clients.
remote, CT, United States$80k – $90k/yrFull TimeSenior (5+ years)Symetra
Review and adjudicate group life and AD&D claims according to policy provisions. Investigate eligibility, gather supporting information, and apply judgment to claim decisions. Identify beneficiaries and issue payments with required approvals.
remote, United States$50k – $83k/yrFull TimeJunior (<2 years)Sedgwick
Analyze and process complex bodily injury auto and commercial transportation claims, ensuring proper documentation and coding. Manage the litigation process for litigated claims and coordinate vendor management, including independent adjusters.
remote, WI, United States$80k/yrFull TimeSenior (5+ years)
Florida Blue
Process and adjudicate healthcare claims, including medical, dental, vision, and mental health claims. Conduct claims research, verify medical necessities, and ensure compliance with policy guidelines. Manage claims investigations, negotiate settlements, and oversee overpayment recovery.
remote, United StatesFull TimeJunior (<2 years)
GuideWell
Process and adjudicate healthcare claims, including medical, dental, vision, and mental health claims. Conduct claims research, verify medical necessities, and ensure compliance with policy guidelines. Facilitate claims investigations, negotiate settlements, and manage overpayment reviews.
remote, United StatesFull TimeJunior (<2 years)
One80 Intermediaries
Review and analyze accident and health claims to ensure accurate processing according to policy provisions. Handle moderate to complex claim issues, obtain necessary documentation, and determine claim approvals or denials. Document required information in the claims system and manage follow-ups.
remote, United States$36k – $38k/yrFull TimeEntry with DegreeOne80 Intermediaries
Review and analyze travel claims to ensure accurate processing according to policy provisions. Handle moderate to complex claim issues, obtain necessary documentation, and determine claims approval or denial.
remote, FL, United States$32k – $42k/yrFull TimeEntry with DegreeSedgwick
Analyze and process Lost-Time Workers Compensation claims, ensuring timely resolution through investigation and information gathering. Negotiate settlements within designated authority and communicate claim activity with claimants and clients.
remote, IL, United States$70k – $75k/yrFull TimeSenior (5+ years)
California FAIR Plan Association
Process and evaluate insurance claims for property losses, ensuring compliance with regulations. Interact with independent adjusters and policyholders, review claim forms, and make payment recommendations.
remote, Los Angeles, CA, United StatesFull TimeJunior (<2 years)California FAIR Plan Association
Manage a caseload of commercial property claims from assignment through resolution. Examine claims investigated by independent adjusters to determine coverage validity. Review and adjust loss reserves, verify coverage, and authorize payments.
remote, Los Angeles, CA, United StatesFull TimeSenior (5+ years)Sedgwick
Analyze and process GL, Auto, BI, and Premises Liability Litigation claims to determine benefits due. Develop action plans for timely resolution, negotiate settlements, and communicate claim activity with claimants and clients. Report claims to excess carriers and respond to requests professionally.
remote, United States$80k – $85k/yrFull TimeSenior (5+ years)Sedgwick
Analyze and process workers compensation claims, developing action plans for timely resolution. Negotiate settlements within designated authority and communicate claim activity with claimants and clients. Report claims to excess carriers and respond to requests professionally and promptly.
remote, CA, United States$60k – $95k/yrFull TimeSenior (5+ years)Sedgwick
Analyze and process liability claims, developing action plans for timely resolutions. Negotiate settlements within designated authority and communicate claim activities with claimants and clients. Report claims to excess carriers and respond to requests professionally and promptly.
remote, CA, United States$80k – $90k/yrFull TimeMiddle (2-4 years)Sedgwick
Analyze and process workers compensation claims, ensuring timely resolution through investigation and information gathering. Negotiate settlements within designated authority and communicate claim activity with claimants and clients.
remote, CA, United States$95k – $105k/yrFull TimeMiddle (2-4 years)
Ameritas
Evaluate and authorize complex claims dispositions. Analyze medical records and financial documents, and initiate medical reviews and examinations. Correspond with policyholders, attorneys, and medical facilities, and collaborate with Legal and Medical/Underwriting departments.
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King'S Insurance Staffing
Manage complex Professional Liability claims throughout the full claims lifecycle, including investigation, evaluation, negotiation, and resolution. Analyze policy provisions to identify coverage and potential concerns. Evaluate liability and damages to establish reserves and settlement strategies.
remote, CA, United States$110k – $125k/yrFull TimeSenior (5+ years)King'S Insurance Staffing
Manage a caseload of complex commercial auto bodily injury claims from assignment through resolution. Review coverage, determine liability, assess damages, and establish claim strategies.
remote, United States$95k – $125k/yrFull TimeSenior (5+ years)
WPS—A health solutions company
Analyze data from anti-fraud software and medical records to identify fraud and abuse. Develop and manage investigative cases, perform pre-payment and post-payment reviews of claims, and compile data for audits.
remote, New Jersey, United States$44k/yrFull TimeMiddle (2-4 years)Raphael and Associates
Manage Construction Defect claims from start to finish, ensuring compliance with policy coverage and state regulations. Conduct investigations to assess damages and liability, and document findings in the claims management system.
remote, Rutherford, NJ, United StatesFull TimeSenior (5+ years)Sedgwick
Analyze and process workers compensation claims, developing action plans for timely resolution. Negotiate settlements within designated authority and communicate claim activity to claimants and clients. Report claims to excess carriers and respond to requests professionally and promptly.
remote, AZ, United States$63k – $90k/yrFull TimeSenior (5+ years)
Venbrook
Manage a caseload of General Liability, Construction Defect, and Professional Liability claims from first notice of loss through resolution. Conduct coverage analysis, issue coverage position letters, and ensure compliance with jurisdictional requirements.
remote, United States$95k – $110k/yrFull TimeSenior (5+ years)10,000,000+ more jobs available!
