What are the responsibilities and job description for the Claims Specialist position at Leading Edge Connections?
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
Salary : $15 - $16