Claims Processor

HealthEdge

Claims Examiner II responsible for adjudicating and processing healthcare claims at UST HealthProof. Collaborating with team members and mentoring juniors within a remote environment.

Posted 6/9/2026full-timeRemote • 🇺🇸 United StatesJunior💰 $25 per hourWebsite

About the role

Key responsibilities & impact

Be responsible for processing assigned claims based on client-specified guidelines or as directed by the team leader
Be responsible for meeting productivity targets, financial and procedural accuracy standards as established by management
Mentor junior members of the team
Collaborate with other team members on special projects as assigned by the team leads; special projects can include process documentation development, training, quality audits, assisting with surge activity for the client(s), or any other project as determined by the team leader
Knowledge base around physician practices and hospital coding, billing and medical terminology, CPT, HCPCS, and ICD-10, UB04, CMS 1500, authorizations, medical terminology, and concepts of healthcare
Establish and maintain an appropriate level of communication with management to address issues and concerns and take preventive measures that ensure processing accuracy and quality

Requirements

What you’ll need

High School degree required
1 - 3 years of healthcare claims processing experience
Solid understanding and ability to analyze claim data
ICD-10 CPT and HCPCS coding, is a plus
Willingness to learn new skills
Team collaborator
Strong work ethic

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account HealthEdge Website LinkedIn All Job Openings 1001 - 5000 employees Founded 2005 ⚕️ Healthcare Insurance ☁️ SaaS 💳 Fintech Healthcare Insurance
SaaS
Fintech HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility. Claims Processor 🔥 0 minutes ago 🇺🇸 United States – Remote 💵 $25 / hour ⏰ Full Time 🟢 Junior 📋 Claims Specialist 🚫👨‍🎓 No degree required 🦅 H1B Visa Sponsor Apply Now Find Hiring Managers Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Be responsible for processing assigned claims based on client-specified guidelines or as directed by the team leader
Be responsible for meeting productivity targets, financial and procedural accuracy standards as established by management
Mentor junior members of the team
Collaborate with other team members on special projects as assigned by the team leads; special projects can include process documentation development, training, quality audits, assisting with surge activity for the client(s), or any other project as determined by the team leader
Knowledge base around physician practices and hospital coding, billing and medical terminology, CPT, HCPCS, and ICD-10, UB04, CMS 1500, authorizations, medical terminology, and concepts of healthcare
Establish and maintain an appropriate level of communication with management to address issues and concerns and take preventive measures that ensure processing accuracy and quality 🎯 Requirements
High School degree required
1 - 3 years of healthcare claims processing experience
Solid understanding and ability to analyze claim data
ICD-10 CPT and HCPCS coding, is a plus
Willingness to learn new skills
Team collaborator
Strong work ethic Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Claims Specialist 🕒 3 days ago Aflac 10,000+ employees 💸 Finance ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Claims Specialist processing Wellness and Hospital Indemnity insurance claims for Aflac. Providing customer service and documentation for policyholders while utilizing database systems. 🇺🇸 United States – Remote 💵 $35k - $45k / year ⏰ Full Time 🟢 Junior 📋 Claims Specialist 🚫👨‍🎓 No degree required 🦅 H1B Visa Sponsor 🗣️🇪🇸 Spanish Required Claims Examiner I 🕒 3 days ago Nakupuna Companies 1001 - 5000 🤝 B2B 🏛️ Government Website LinkedIn All Job Openings Claims Examiner I conducting claims intake and investigation while ensuring compliance with procedures. Collaborating with senior claims personnel and maintaining electronic case files. 🇺🇸 United States – Remote 💵 $65k - $85k / year ⏰ Full Time 🟢 Junior 🟡 Mid-level 📋 Claims Specialist Claims Adjuster – Associate 🕒 4 days ago Independence Pet Holdings 1001 - 5000 ⚕️ Healthcare Insurance 👥 B2C 🧘 Wellness Website LinkedIn All Job Openings Claims Adjuster Associate investigating and evaluating insurance claims for Pumpkin, a pet health company. Collaborating with veterinary hospitals and policyholders to ensure appropriate compensation for claimed losses. 🇺🇸 United States – Remote ⏰ Full Time 🟢 Junior 🟡 Mid-level 📋 Claims Specialist Claims Examiner 🕒 4 days ago Imagenet LLC 1001 - 5000 ⚕️ Healthcare Insurance 🛍️ eCommerce ☁️ SaaS Website LinkedIn All Job Openings Claims Examiner processing medical claims for healthcare services at Imagenet LLC. Ensuring compliance with payer requirements and internal policies remotely. 🇺🇸 United States – Remote 💵 $17 - $18 / hour 💰 Private Equity Round on 2022-12 ⏰ Full Time 🟢 Junior 🟡 Mid-level 📋 Claims Specialist 🚫👨‍🎓 No degree required Pharmacy Claims Representative 2 🕒 4 days ago Dragonfly Health 1001 - 5000 🤝 B2B ☁️ SaaS 💊 Pharmaceuticals Website LinkedIn All Job Openings Pharmacy Claims Representative reviewing and processing pharmacy claims for Dragonfly Health. Work remotely in a remote call center environment with evening hours and weekends. 🇺🇸 United States – Remote 💵 $22 / hour 💰 Secondary market on 2021-12 ⏰ Full Time 🟢 Junior 📋 Claims Specialist 🚫👨‍🎓 No degree required View More Claims Specialist Jobs 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs

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Hard Skills & Tools

healthcare claims processingICD-10CPTHCPCSclaim data analysisbillingmedical terminologyUB04CMS 1500authorizations

Soft Skills

mentoringcollaborationcommunicationstrong work ethicteamworkproblem-solvingattention to detailadaptabilitytime managementproductivity