Experienced Managed Care Claims Examiner - U.S. Remote
Imagenet · United States · US
Other
Remote
Not yet analysed
Demand72
Career growth55
Healthcare fit42
Remote potential95
5-year outlook
Stable payer-operations role with modest salary growth; advancement likely comes through claims auditing, coding, quality review, or team leadership rather than clinical progression. Exact pay is not stated.
Clinical license
Not required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-24
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth considering only if you already have payer, claims, billing, or managed-care operations experience. Clinicians without claims adjudication experience may find the 3-year requirement a significant barrier.
Who should apply
Healthcare administrators, billing/claims professionals, nurses with payer or insurance operations experience, and healthcare graduates with managed-care claims exposure.
CV angle
Emphasize real payer, billing, coding, insurance verification, appeals, compliance, and high-volume documentation experience; translate clinical chart review and regulatory familiarity into claims adjudication language without claiming claims experience you do not have.
Skills to highlight
- Medical claims adjudication
- Managed care
- Reimbursement methodologies
- Provider dispute and appeals resolution
- Benefit verification and eligibility
- Medical coding and documentation accuracy
- Regulatory compliance
- High-volume production and quality metrics
Role summary
A remote U.S. managed-care claims examiner role responsible for reviewing, investigating, adjudicating, and resolving medical claims and provider disputes under payer guidelines, contracts, and regulations.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.