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Remote Medical Claims Processor jobs in the United States
Job type
Min. salary, $/year
Level
The demand for a skilled medical claims processor continues to grow as healthcare organizations across the USA expand their remote operations. With 500+ open positions available, this remote opportunity allows professionals to join a dynamic field that blends healthcare knowledge with administrative precision. Employers nationwide are actively looking to hire a medical claims processor who can keep pace with evolving billing systems and compliance standards.
Success in this role requires strong attention to detail, familiarity with medical coding systems such as ICD-10 and CPT, and the ability to interpret insurance policies accurately. Candidates should be comfortable navigating claims management software, verifying patient information, and resolving discrepancies efficiently. Strong communication skills are essential, as the role often involves coordinating with healthcare providers, insurers, and patients to ensure timely claim resolution. Analytical thinking and organizational skills help maintain accuracy across high volumes of medical claims vacancies in a fast-paced environment.
Remote work has become the standard for many claims-related roles, offering flexibility while maintaining the structure needed to meet strict processing deadlines. Companies across the USA are increasingly offering remote medical claims positions to attract talent regardless of geographic location, reflecting a broader shift toward digital-first healthcare administration. This trend has created a competitive market where organizations seek reliable professionals who can work independently while staying connected to distributed teams.
If you are ready to take the next step in your healthcare administration career, explore current medical claims processor jobs in the USA through Global Work AI. Discover opportunities that match your experience and skillset, and connect with employers eager to bring dedicated professionals onto their remote teams today.
Sedgwick
Analyze and process complex medical malpractice claims, conducting investigations and managing claims to resolution. Negotiate settlements, calculate reserves, and coordinate legal defense while ensuring compliance with client guidelines.
remote, United States$125k/yrFull TimeSenior (5+ years)
Gallagher
Manage the full claim life cycle for Healthcare Professional Liability claims, including coverage analysis, investigation, evaluation, and resolution.
remote, United States$165k/yrFull TimeSenior (5+ years)
EverCommerce
Investigate and resolve complex claims and reimbursement issues. Analyze denial trends to improve claim outcomes and support the reduction of aged accounts receivable. Collaborate with internal teams to implement solutions that enhance operational efficiency and financial performance.
remote, United States$36k – $44k/yrFull TimeJunior (<2 years)Apply for the Remote Insurance Claims Specialist job
Manage the insurance claims process from start to finish, including reviewing and analyzing claims, ensuring timely documentation, and communicating with insurance providers.
remote, Houston, TX, United States$36k – $77k/yrFull TimeMiddle (2-4 years)
Crawford & Company
Manage medical-only and maintenance claims, ensuring accurate processing and payment approvals. Review and update claims data in a computerized system, contact claimants and medical providers for information, and document medical reports.
remote, United StatesFull TimeJunior (<2 years)
SCAN Health Insurance
Conduct pre-pay and post-pay audits of claims payments and denials to ensure accuracy. Ensure compliance with regulatory standards and maintain quality by utilizing knowledge of claims processing.
remote, United States$51k – $74k/yrFull TimeMiddle (2-4 years)
TEKsystems
Review and adjudicate medical claims, determining approval, denial, or additional information needs. Process claims according to benefit plans and medical policies, ensuring accuracy in coding and documentation. Investigate pending claims and apply necessary adjustments.
remote, WI, United States$39k/yrFull TimeJunior (<2 years)
Jobgether
Manage accounts receivable activities by reviewing and processing medical claims. Investigate unpaid, denied, or underpaid claims to identify discrepancies and implement corrective actions.
remote, United States$36k – $48k/yrFull TimeJunior (<2 years)TEKsystems
Review, analyze, and process medical claims for payment according to plan benefits and medical policies. Ensure claims are complete, accurate, and compliant with billing standards.
remote, WI, United States$39k/yrFull TimeJunior (<2 years)
United Regional
File insurance claims using UB-04 and CMS 1500 forms, compute insurance benefits, and process reimbursements from payers. Investigate and correct patient account discrepancies, ensure timely filing of claims, and follow up on payments or denials.
remote, Wichita Falls, TX, United StatesFull TimeJunior (<2 years)
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)
Imagine360
Coordinate the receipt, tracking, and documentation of stop loss claims submissions. Compile periodic reporting, communicate with third-party administration staff, and process claims. Review claims for appropriateness and facilitate funding with Finance.
remote, United StatesFull TimeJunior (<2 years)
Trillium Health Resources
Manage and coordinate claim issues from providers and members via calls, emails, and ticket systems. Conduct claims research, update claims ticket queues, and draft provider communications.
remote, NC, United States$56k – $70k/yrFull TimeSenior (5+ years)TEKsystems
Examine and process paper and electronic claims, determining whether to return, pend, deny, or pay claims. Adjudicate claims according to policies, resolve issues, and ensure compliance with billing standards.
remote, WI, United States$39k/yrFull TimeJunior (<2 years)
NTT DATA Services
Process professional claim forms, review policies and benefits, and ensure compliance with HIPAA regulations. Research and adjudicate claims independently, meeting turnaround times and quality targets. Maintain quality scores and respond to claims received via email in a timely manner.
remote, Plano, TX, 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)
EMC Insurance Companies
Investigate and manage medical-only workers’ compensation claims, verifying coverage and compensability. Communicate with insureds and injured employees to gather information and provide updates. Establish reserves, maintain claim documentation, and issue payments.
remote, United States$47k – $71k/yrFull TimeJunior (<2 years)TEKsystems
Review, analyze, and adjudicate medical claims according to plan benefits and policies. Determine claim disposition and verify accuracy and compliance of submitted documentation. Process approved claims, investigate pending claims, and maintain documentation of claim decisions.
remote, WI, United States$39k/yrFull TimeJunior (<2 years)
Pinnacol Assurance
Review and validate medical bills for workers' compensation claims, ensuring compliance with DOWC rules. Process CMS 1500 and UB04 forms, verify accuracy of fee schedules, and determine if additional reviews are needed.
remote, CO, United States$54k – $58k/yrFull TimeJunior (<2 years)
Centivo
Oversee health claims processing for self-funded employer groups, managing claim supervisors and analysts. Set productivity goals and quality metrics, ensuring compliance with benefit plans and pricing agreements.
remote, NY, United StatesFull TimeLead / ManagerGallagher
Support Claims Examiners in managing workers' compensation claims, including setting up claims files, processing payments, and conducting wage calculations. Monitor claims for potential penalties, manage correspondence, and coordinate medical appointments.
remote, United States$45k – $55k/yrFull TimeJunior (<2 years)
PharMerica
Manage and resolve pharmacy claims, ensuring maximum payer reimbursement and timely billing. Research and analyze rejected claims, working with Medicare D plans and insurance companies.
remote, United StatesFull TimeJunior (<2 years)
Avesis
Oversee Claims Supervisors and processing staff, ensuring timely and accurate claims processing. Lead workflow oversight, error reduction initiatives, and execution of claim payment procedures.
remote, United States$74k – $145k/yrFull TimeLead / Manager
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)
Sana Benefits
Process insurance claims accurately and timely, ensuring adherence to health plan policies. Gather and verify claim information, research issues, and communicate outcomes to claimants. Maintain detailed records of claims processed and support Customer Success teams with claims-related inquiries.
remote, United States$43k – $59k/yrFull 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 Degree
DELTA HEALTH SYSTEMS MCC
Assist in supervising staff, including training and directing work. Respond to inquiries from staff and customers, manage tasks and inventory, and ensure adherence to department guidelines.
remote, CA, United States$50k – $54k/yrFull TimeJunior (<2 years)
GLOBALHEALTH HOLDINGS LLC
Process all types of contracted and non-contracted claims accurately and timely for Medicare, Medicaid, and Commercial Insurance products. Collaborate with the Claims Supervisor on reviewing processed claims to ensure accuracy and compliance.
remote, OK, United StatesFull TimeJunior (<2 years)
Allied Benefit Systems
Lead teams to ensure claims are processed according to Service Level Agreements and regulatory standards. Monitor inventory and quality reports, manage elevated authority claim reviews, and oversee client performance requirements.
remote, IL, United States$70k – $85k/yrFull TimeLead / Manager
Sagility
Review and process medical claims for accuracy and completeness, ensuring compliance with CMS guidelines and client policies. Navigate multiple systems to verify pricing and authorizations, determine claim payment or denial, and prepare denial letters as needed.
remote, United States$34k/yrFull TimeJunior (<2 years)
Radiology Partners
Review and submit medical claims to insurance payers, ensuring compliance with regulations. Validate patient and claim data for accuracy, resolve claim edits and rejections, and collaborate with Revenue Cycle teams to address issues.
remote, United States$36k – $40k/yrFull TimeMiddle (2-4 years)
Summit Insurance Group, Inc.
Manage an inventory of claims to evaluate compensability and liability. Conduct claim investigations to confirm coverage and determine damages. Negotiate claim settlements within authority limits and maintain accurate claim files. Authorize payments and ensure timely resolution of claims.
remote, Illinois, United States$70k – $92k/yrFull TimeSenior (5+ years)TRILLIUM HEALTH RESOURCES
Analyze and audit claims adjudication results for accuracy according to NC Medicaid guidelines. Finalize adjudication results through data analysis and research of billing guidelines. Assist providers with claims processing inquiries and communicate with stakeholders to resolve claims efficiently.
remote, NC, United States$43k – $62k/yrFull TimeJunior (<2 years)
MagnaCare
Lead and develop remote claims teams, ensuring high performance and compliance with collective bargaining agreements. Oversee daily claims operations, manage escalated issues, and implement process improvements. Conduct audits, performance evaluations, and develop training programs for new hires.
remote, NV, United StatesFull TimeLead / Manager
CROWN ADMINISTRATORS
Lead a team of 4-7 Claims Processors, overseeing daily claims processing tasks and ensuring timely handling of member claims. Serve as the primary contact for escalated issues, assist in training staff, and monitor department performance by tracking KPIs.
remote, TX, United StatesFull TimeLead / Manager
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.
remote, United StatesFull TimeSenior (5+ years)
CorVel Corporation
Manage non-complex medical only Workers’ Compensation claims, confirming policy coverage and claim acknowledgment. Determine claim validity and compensability, establish reserves, and authorize payments.
remote, United States$34k – $54k/yrFull TimeJunior (<2 years)Crawford & Company
Administers non-complex short term claims, conducting investigations to confirm coverage and determine liability. Verifies policy coverage, establishes reserve requirements, and approves payments of medical bills.
remote, Boise, ID, United StatesFull TimeJunior (<2 years)
Conduent State Healthcare, LLC
Lead the claims module for MMIS health care projects, providing domain knowledge and analysis of business requirements. Design and develop documentation, ensuring quality processes while coordinating with customers.
remote, United States$85k – $111k/yrFull TimeSenior (5+ years)10,000,000+ more jobs available!
