Claims Specialist Job at Leading Edge Connections, West Virginia

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  • Leading Edge Connections
  • West Virginia

Job 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

Job Tags

Contract work, For contractors, Remote work, Home office, Monday to Friday

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