Medical Claims Examiner
This is the employer's own posting, not a copy on a job board.
What we know
Is it still open?
Confirmed still open
Last checked 1d ago — checked against the employer's own applicant tracking system, which is the company answering directly.
We re-read the employer's own applicant tracking system and the posting was still there. That is the company answering directly.
How old is it?
Posted 103d ago
The date the source published, not the day we noticed it (2026-07-22). Last seen at its source 5h ago.
We have tracked this listing since 9 Sep 2026 (54 days). The employer's own board has carried it every time we have read it, most recently 5 hours ago.
Is it remote?
Marked remote on the employer's board
Their board carries a remote setting on this posting — a field they filled in, not wording we read. The location field names somewhere specific, which is usually where the team or the entity sits.
Who may apply?
United States
The description states no restriction of its own. This is the source's own tag.
Skills named in the ad
Recognised terms only, from a fixed vocabulary — this is what CV matching compares against.
Carried by 1 source
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Workable employer's own board first seen 54d ago · last seen 5h ago
The listing
We are seeking a highly skilled and independent Claims Examiner to join our team on a 100% remote, 1099 contract basis. In this role, you will be responsible for the accurate and timely processing of self-funded medical health insurance claims.
Because this is a fully remote, independent contractor position, we are looking for a self-starter who requires minimal supervision and has deep, hands-on experience navigating the WLT software system. Your expertise will directly ensure our claims are adjudicated accurately according to specific plan documents and TPA guidelines.
Key Responsibilities
- Review, analyze, and process complex self-funded medical claims from start to finish.
- Utilize the WLT system daily to adjudicate claims, ensuring all coding, billing, and pricing rules are applied correctly.
- Verify patient eligibility, benefit limits, and plan coverage exclusions based on specific self-funded plan documents.
- Identify and investigate claims requiring additional information, such as coordination of benefits (COB), subrogation, or medical necessity reviews.
- Maintain strict compliance with all federal and state regulations, including HIPAA and ERISA guidelines.
- Meet or exceed established quality accuracy and production turnaround standards.
Requirements
Required:
- WLT System Experience: Proven, hands-on experience adjudicating claims within the WLT software platform. (Candidates without WLT experience will not be considered).
- Self-Funded Expertise: Demonstrated background processing self-funded medical health insurance claims.
- Contractor Readiness: Ability to work independently as a 1099 contractor, managing your own remote office setup and schedule to meet production targets.
- Technical Setup: A secure, HIPAA-compliant home office environment with high-speed internet.
Ideal / Preferred:
- TPA Experience: Previous experience working within a Third Party Administrator (TPA) environment is highly preferred and will make you a standout candidate.
- Deep understanding of medical terminology, CPT, ICD-10, HCPCS codes, and standard billing forms (UB-04, CMS-1500).
Why Partner With Us?
- Total Flexibility: 100% remote work structure from anywhere in the U.S.
- Competitive Rate: Straightforward compensation at $30.00 per hour.
- Autonomy: As a 1099 contractor, you have the independence to do what you do best without corporate micromanagement.