Claims Specialist

🏢 Leading Edge Connections · all Leading Edge Connections jobs
📍 United States
📅 Posted 2026-08-21 · via Himalayas
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Claims Specialist – Remote Healthcare Administrative Agent

Join LEC as a remote Healthcare Administrative Support Representative, helping healthcare clients manage insurance claims and payer-related inquiries. In this role, you’ll make outbound calls to insurance companies, navigate payer IVR systems, speak with claims representatives, and accurately document results in the client’s platform.
Key Responsibilities

- Follow up on claim status, including processed, approved, denied, delayed, and paid claims.

- Inquire about claim adjudication and payment timelines.

- Request missing documentation and clarification of denial reasons.

- Clarify appeal requirements and prior authorization status.

- Perform eligibility verification and provider credentialing status checks.

- Ask structured, predefined questions and accurately record responses.

- Navigate IVR systems and remain professional while managing hold times.

- Maintain accurate documentation and complete follow-up tasks in required systems.

- Meet client performance, quality, accuracy, and productivity expectations.

Qualifications

- 1–2 years of call center or customer service experience preferred.

- Healthcare, insurance, claims, or revenue cycle experience is a plus.

- Strong communication, active listening, typing, and multitasking skills.

- Comfortable working with multiple systems and documenting information accurately.

- Ability to work independently while following established processes and scripts.

- High School Diploma or equivalent required.

Position Details

- Remote / Work From Home

- 1099 Independent Contractor

- Paid Training

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Pay: $15–$15.50/hour

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Schedule: Monday–Friday, 9:30 AM–6:00 PM EST

Hardware/Software Requirements

- To be successful in this role, you must have your own computer and home office setup that meets the following minimum specifications:

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Personal computer (laptop or desktop only; no Chromebooks, MacBooks, iPads, netbooks, or tablets).

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Processor: Intel® Core™ i5 5200 series or greater; all computers must have at least 4 performance cores .

- Example: A 10-core computer with only 2 performance cores does not meet this requirement.

- Please check your system settings to confirm.

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Memory: 8GB RAM minimum; Windows 11 (64-bit) or higher.

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Display: Screen resolution of 1280x768 or higher; dual monitors required for efficiency.

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Internet: Reliable high-speed internet with a wired Ethernet connection (hardwired to router).

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Audio: USB noise-canceling headset.

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Security: Up-to-date antivirus software with a recent scan completed; firewall must be enabled

- ** Must have a wired USB headset with a microphone ** (Please use this in your interview)

Must have a High School Diploma or equivalent

Originally posted on Himalayas

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