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Leading Edge Connections, LLC. Linkedin · Posted 5d ago

Claims Specialist

West Virginia, United States

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Indexed description

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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