Remote Claims Processor (NJ Healthcare)

Shape Healthcare Experiences from Anywhere

Every claim tells a story. As a Remote Claims Processor focused on the NJ healthcare sector, you'll bring clarity and confidence to every member interaction, guiding claims through a journey that blends accuracy, empathy, and efficiency. This role isn’t just about numbers or forms—it’s about giving real people the peace of mind they need, knowing their coverage is in good hands. If your passion is to transform complex healthcare processes into simple, reassuring outcomes, here’s your chance to make your impact felt from day one.

What Makes This Role Meaningful

Imagine the relief on a patient’s face when their claim gets resolved—quickly, fairly, and without hassle. Your decisions will directly influence patient well-being, family finances, and the trust placed in a healthcare system. The process you streamline helps healthcare providers focus on care, not paperwork. It’s a ripple effect: resolve one claim efficiently, and you unlock better health journeys for countless individuals. This is work that matters, every single day.

Key Responsibilities: More Than Just Processing

• Guide claims from submission through resolution—ensuring every touchpoint is accurate, compliant, and timely.
• Review medical documentation with precision, turning industry jargon into actionable outcomes.
• Address questions and concerns with empathy, whether connecting with patients, providers, or insurance partners.
• Analyze claim patterns and flag inconsistencies—your attention to detail helps prevent costly errors and fraud.
• Partner with technical and member support teams to simplify every step, using digital tools for seamless workflows.
• Resolve escalated issues quickly, always prioritizing clarity and fairness over rote processes.
• Stay informed about new regulations as they emerge and adjust our processes accordingly, ensuring our team remains one step ahead.

Tools & Technology: Your Digital Workspace

You'll thrive in a fully remote environment, equipped with modern claims processing software, electronic health record (EHR) platforms, and secure communication channels. Master digital tools to track claim status, upload supporting documents, and manage detailed workflows. Familiarity with healthcare regulations (HIPAA, Medicaid/Medicare, and state guidelines) will be a key advantage. Comfortable with data privacy protocols? Great—it's essential to our trust-driven approach.

What Success Looks Like

Picture yourself closing your workday knowing you helped dozens of people understand their coverage, resolve billing confusion, and access critical care. Accuracy isn’t just a metric; it’s how you build trust in our brand. You’ll stay on top of industry updates, proactively sharing insights with your team so everyone benefits. Each interaction—whether over the phone, chat, or email—leaves members feeling heard and supported.

Desired Skills & Experience

• Deep understanding of healthcare claims processes, ICD-10 and CPT coding, and insurance regulations.
• You simplify complex ideas—whether it’s over Zoom, Slack, or a detailed claim note.
• Experience using remote collaboration tools to keep communication flowing smoothly across time zones.
• Analytical mindset—you spot trends in claim data and suggest improvements that boost team results.
• Empathy for members navigating a confusing system; your words make all the difference.
• Adaptability is required as technology, guidelines, and claim volumes shift from week to week.
• Experience in the NJ healthcare landscape is a strong plus.

Work Environment: Designed for Focus & Flexibility

You’ll have the space to think deeply and the autonomy to approach challenges your way. Our team moves quickly, but you’ll never lose sight of what matters most: people. As part of a tight-knit remote group, you’ll partner with claims experts, care navigators, and technical specialists—each invested in making healthcare more accessible. Structured onboarding and ongoing support mean you’re set up for success from your first claim onward.

Compensation & Growth

For this impact-driven position, the annual salary is **$41,110, **reflecting both the responsibility and the opportunity to make a difference in the NJ healthcare system. Alongside competitive pay, you’ll enjoy access to professional development resources, regular feedback, and a team culture built on respect and growth.

Ready to Build Better Healthcare?

If you thrive in remote environments, love connecting dots in complex systems, and want every workday to make a genuine difference, this role was written for you. Your insights, initiative, and drive will shape how thousands of people experience healthcare in New Jersey. Let’s turn challenges into opportunities and create clarity where others see only confusion. If you’re excited to help patients and providers from behind the scenes, we’re excited to connect with you.