Remote Health Claims Adjuster

Introduction: A Mission Rooted in Care and Equity

Imagine joining a team where your analytical mind and compassionate heart unite for a greater purpose. As a Remote Health Claims Adjuster, you'll be the voice of empathy and clarity to individuals navigating life’s most vulnerable moments. In this role, you're not just managing data—you’re delivering peace of mind. Our organization, known for its inclusive workplace and diverse team, celebrates every background and strives to uplift each employee with dignity and respect. We believe that supporting our clients begins with helping our people, and we're excited to welcome someone who shares that belief.

Key Responsibilities

Primary Duties

• Evaluate health insurance claims with accuracy, fairness, and a commitment to integrity.
• Review medical documentation, provider notes, and policy guidelines to determine coverage eligibility.
• Communicate decisions compassionately to policyholders, healthcare providers, and internal teams.
• Maintain compliance with HIPAA regulations and all relevant state/federal guidelines.

Technical Processes

• Utilize electronic health records systems and claims management software to document findings.
• Investigate discrepancies or unusual billing patterns using critical thinking and attention to detail.
• Collaborate with cross-functional teams—including nursing, legal, and provider relations—for complex claim reviews.
• Uphold the values of an equal opportunity employer by ensuring each claim is handled without bias.

Inclusive Work Environment

A Culture of Collaboration and Belonging

Working here means being part of a compassionate remote team that values connection over competition. Weekly check-ins, team-building activities, and DEI training are not just checkboxes—they’re the pulse of our culture. We foster a psychologically safe environment where unique viewpoints are encouraged, and each team member is genuinely acknowledged and respected at the virtual table. Whether you’re based in a city apartment or a rural home office, you’re embraced as part of our vibrant, inclusive network.

Tools & Technology

Empowering Digital Tools

• Secure cloud-based claims adjudication systems
• Real-time collaboration platforms like Slack and Zoom
• HIPAA-compliant medical review databases
• AI-assisted billing code validation tools
• EHR integrations for streamlined access to health records

Learning Resources

You’ll also be granted access to training portals and certification programs designed to help you grow into a well-rounded remote insurance specialist.

Qualifications

Experience and Knowledge

• Proven experience in healthcare claims adjusting or related health insurance roles (minimum 2 years preferred)
• Strong knowledge of ICD-10, CPT coding, and medical terminology
• Familiarity with state health insurance regulations and claim adjudication standards

Skills and Attributes

• Ability to analyze complex claims and explain resolutions with clarity and care
• Comfort working in a remote environment with self-discipline and accountability
• A sincere commitment to fostering inclusivity and empathy in daily interactions
• Excellent written and verbal communication skills
• Bachelor’s degree in healthcare administration, insurance, or a related field preferred

Real Stories of Belonging

One of our team members, a single parent living in a rural community, shared how this remote position gave them the flexibility to support their family while contributing meaningfully to the lives of others. Another claims adjuster, originally from a non-traditional background, now leads a mentorship circle that supports new hires from underrepresented communities. These stories remind us that talent thrives where trust, empathy, and opportunity intersect.

Compensation and Benefits

Salary Details

This full-time remote opportunity offers an annual salary of $65,895.

Benefits Overview

• Comprehensive health, dental, and vision coverage
• Generous PTO and mental health days
• Paid volunteer time and parental leave
• Home office stipend and tech support
• Continuous DEI workshops and growth coaching

We don’t just offer a job—we offer a community that honors your journey and empowers your future.

Call to Action

Apply with Heart

If you're passionate about improving healthcare outcomes while working in a supportive, diverse, and inclusive workplace, we encourage you to join us. This is your chance to apply your healthcare knowledge, adjuster expertise, and human empathy where it counts most.

Step into a role where compassion meets accuracy, and every claim is a chance to make someone’s day a little easier.

Apply now and bring your purpose to life—right from where you are.