Remote Claims Processor at Health Admins

Health Admins is hiring a Remote Claims Processor to support medical claims processing, healthcare reimbursement, claims audits, and client service operations. This full-time remote role offers a strong opportunity for detail-oriented professionals who understand healthcare claims, medical terminology, insurance billing, and documentation accuracy.

This Remote Claims Processor role fits best as a low-phone healthcare position. The job includes responding to member and provider inquiries, but the core responsibilities focus on reviewing claims, verifying claim details, auditing documentation, researching billing issues, and resolving discrepancies. It does not read like a high-volume call center role.

Daily responsibilities include reviewing and processing medical claims submitted by members or providers. The Claims Processor verifies patient demographics, diagnoses, procedures, billing codes, and supporting documentation when available. The role also requires strong accuracy, because each claim must meet insurance policies, reimbursement rules, coding guidelines, and industry standards.

The Claims Processor also investigates claim issues and conducts audits to identify errors, discrepancies, or possible fraudulent activity. This includes analyzing medical records, billing statements, reimbursement policies, and legal requirements to determine the correct claim outcome. Candidates who enjoy research, compliance review, and problem-solving may find this role highly aligned with their strengths.

This position also supports customer service needs by serving as a primary contact for claims questions and resolution. The Claims Processor responds to inquiries with professionalism and empathy while working with internal teams to resolve issues in a timely manner.

Health Admins seeks candidates with a high school diploma or equivalent and proven experience in medical claims processing and healthcare reimbursement. Strong knowledge of medical terminology, coding, insurance billing, claims management software, Salesforce, and Google Suite may help candidates stand out.

Overall, this Remote Claims Processor role is a strong fit for applicants who want a healthcare back-office position with claims review, auditing, documentation, reimbursement research, and limited phone interaction. It works especially well for candidates with claims, billing, fraud review, compliance, healthcare administration, or data accuracy experience.