Help members get the benefits they’re owed as a work-from-home Claims Examiner. This full-time remote role is perfect if you’re detail-oriented, comfortable with data, and ready to build experience in healthcare claims and insurance from your home office.
About Firstsource
Firstsource is a global Business Process Management (BPM) company that supports Fortune 500 and FTSE 100 clients across healthcare, telecom, media, banking, and insurance. They help organizations modernize operations, improve outcomes, and deliver better customer experiences through tech-enabled services and right-shore delivery centers. As a Claims Examiner, you’ll be part of their Health Plan and Healthcare Services team, focused on accurate and timely claims decisions.
Schedule
- Full-time, hourly position (non-exempt)
- Standard schedule: approximately 8:00 a.m. – 4:30 p.m. local time
- 100% remote, work-from-home role (must be able to sit for prolonged periods)
- Must be able to download/authenticate via 2-factor apps and pass pre-employment background checks
What You’ll Do
- Review healthcare insurance claims to determine validity, completeness, and adherence to policy terms
- Collect, organize, and analyze supporting documentation (EOBs, medical records, policy details, etc.)
- Verify coverage, benefits, and applicable insurance guidelines before finalizing decisions
- Investigate claims as needed, which may include coordinating with internal teams or other stakeholders
- Evaluate loss or service details and determine appropriate settlement or payment amounts
- Recommend claim approvals, denials, or adjustments and process them in a timely, accurate manner
- Enter and update claim data in internal systems with high attention to detail
- Stay aligned with HIPAA, internal policies, and relevant regulatory standards
- Generate or support reports on claim status, trends, and productivity as requested
- Provide clear, professional communication to internal partners regarding claim decisions and issues
What You Need
- High school diploma or equivalent required
- Prior experience with healthcare claims processing strongly preferred (CPT/ICD codes, EOBs, insurance rules)
- Familiarity with claims platforms (such as QNXT) and basic medical terminology is a plus
- Strong data entry accuracy and comfort working with large volumes of information
- Solid analytical and problem-solving skills for resolving discrepancies or denied claims
- Clear written and verbal communication skills with a professional tone
- Ability to adapt to changing priorities, volumes, and system updates
- Customer-service mindset with awareness of how claims decisions affect member experience
- Ability to maintain confidentiality and comply with all privacy and security requirements
- Reliable remote work setup with the ability to sit, type, and work on a computer for extended periods
Benefits
- Pay rate: $14.00 per hour (non-exempt hourly role)
- Remote work-from-home environment with no commute
- Experience in health plan and healthcare services that can grow into broader revenue cycle or insurance roles
- Training on claims systems, healthcare guidelines, and internal processes
- Opportunity to work with a global organization supporting major U.S. health plans and insurers
This is a solid fit if you’re detail-driven, comfortable in a structured environment, and want a remote role that builds real, transferable experience in healthcare and insurance.
Happy Hunting,
~Two Chicks…