Claims Specialist

 Posted 2 days ago
     
 $15 - $15.5 per hour
  
0-2 years experience
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AI Summary

The Claims Specialist manages insurance claims and payer inquiries by making outbound calls and navigating IVR systems. They are responsible for documenting results, verifying eligibility, and following up on claim statuses and denials.

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
  • Pay: $15–$15.50/hour
  • 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:
  • Personal computer (laptop or desktop only; no Chromebooks, MacBooks, iPads, netbooks, or tablets).
  • 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.
  • Memory: 8GB RAM minimum; Windows 11 (64-bit) or higher.
  • Display: Screen resolution of 1280x768 or higher; dual monitors required for efficiency.
  • Internet: Reliable high-speed internet with a wired Ethernet connection (hardwired to router).
  • Audio: USB noise-canceling headset.
  • 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

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