Remote Medicaid Claims Processor

Transform Healthcare Through Technology—From Anywhere

Are you ready to revolutionize healthcare processing from the comfort of your home? As a Remote Medicaid Claims Processor, you'll play a key role in streamlining healthcare claims while contributing to a tech-forward system that’s built on precision, agility, and innovation. With an annual salary of $40,497, this role offers consistency, remote autonomy, and opportunities for advancement within a data-driven environment that values both your technical skills and problem-solving mindset.

Key Responsibilities That Make an Impact

Review & Adjudicate Claims

Analyze Medicaid claims to determine eligibility, accuracy, and compliance with federal and state guidelines. Use proprietary software tools and claim processing systems to assess details efficiently and with absolute precision.

Data Verification & Entry

Leverage automation and digital dashboards to verify patient demographics, coding integrity, provider information, and service authorization details. Maintain complete and auditable digital records.

Communication & Collaboration

Coordinate with cross-functional teams through secure messaging platforms like Microsoft Teams and Slack. Communicate with providers to request clarifications or documentation when discrepancies arise.

Performance Reporting

Utilize real-time analytics tools and dashboards to track claims cycle times, identify error trends, and report processing metrics to supervisors. Engage in continuous improvement initiatives to meet departmental benchmarks.

Compliance Monitoring

Adhere to HIPAA regulations and internal audit protocols. Follow procedural updates in Medicaid regulations using a secure knowledge management portal updated in real-time.

Your Future Tech Environment

Tools You'll Use

• Claims Management Systems (CMS): Modern interfaces optimized for remote users.
• Data Visualization Dashboards: Tools like Tableau, Power BI for performance monitoring.
• Secure File Transfer Protocols (SFTP): For encrypted documentation handling.
• Cloud Collaboration Suites: Google Workspace, Microsoft 365 for secure cross-department interactions.

Frameworks That Drive Efficiency

• OCR Technology: Automates form reading and reduces manual entry errors.
• AI-Powered Pre-Screening Engines: Flag anomalies in real-time.
• Workflow Automation Tools: Streamlines repetitive claim checks and prioritizes urgent cases.

Measurable Impact You’ll Be Part Of

• Reduced claim processing errors by 34% over the last fiscal year.
• Enhanced turnaround times by an average of 22 hours per claim using AI-driven screening.
• Team contributed to $11.2 million in recovered Medicaid reimbursements through accurate claim resolution.

Qualifications to Excel Remotely

• Educational Background: High school diploma required; associate degree in healthcare administration, medical billing, or related field preferred.
• Experience: 1–2 years in Medicaid claims processing or healthcare revenue cycle management.
• Technical Aptitude: Proficiency with EMR systems, claims databases, and spreadsheet software like Excel or Google Sheets.
• Analytical Skills: Familiarity with CPT/ICD coding structures, claim lifecycle logic, and Medicaid eligibility verification procedures.
• Remote-Ready Mindset: Self-motivated, organized, and able to work within deadline-driven virtual environments.

Work Culture That Fosters Growth

We believe remote work should be more than just flexible—it should be empowering. Our claims team operates in a collaborative digital workspace, where innovation is championed, ideas are welcomed, and outcomes are celebrated. You'll attend virtual team huddles, engage in quarterly innovation labs, and receive ongoing coaching from tenured Medicaid billing specialists.

Weekly Digital Wellness Checks

• Real-time feedback loops
• Stress management apps
• Virtual peer support circles

Training You Can Count On

• Monthly virtual workshops on policy changes
• Annual credentialing in Medicaid compliance systems
• Mentorship with experienced processors using asynchronous chat support

Career Progression & Development

• Advance to Medicaid Compliance Specialist or Remote QA Auditor roles within 12–18 months.
• Access internal learning modules on machine learning in claims adjudication.
• Be first in line for leadership training through the company’s virtual Leadership Launchpad program.

Why You Should Apply Today

This role offers you the opportunity to redefine healthcare efficiency from the comfort of your home office. Join a future-focused team where your work not only improves claim accuracy but also directly supports timely access to care for vulnerable populations. Your tech-savviness and dedication will help us reshape the Medicaid experience with empathy and precision.

Your Next Step—Be the Engine of Change

Make your next career move matter. Apply now to become a Remote Medicaid Claims Processor and help modernize the nation’s healthcare claim ecosystem. Be part of a team that transforms policy into action and data into solutions. This isn’t just a job—it’s your platform to drive change.