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Claims Specialist

Role overview

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
  • High School Diploma or equivalent required

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

Key facts

Other skills

  • Customer Service
  • Communication
  • Active Listening
  • Typing
  • Multitasking

About the company

Leading Edge Connections logo

Leading Edge Connections

Customer Experience & Contact Centers

Leading Edge Connections is a cutting-edge virtual contact center that has established itself as the number one player in the industry in America. Founded in 2017 by Jon Juliano and Eric Sims, Leading Edge Connections has redefined the traditional contact center model by embracing remote work as its core operating principle. As a fully remote organization, Leading Edge Connections leverages the latest technology and innovative strategies to deliver exceptional customer experiences for its clients. With a team of highly skilled and talented remote agents located across the United States, Leading Edge Connections provides unparalleled customer support, sales, and lead generation services to businesses of all sizes and across various industries. At Leading Edge Connections, the team is driven by a shared passion for excellence and a commitment to delivering results. Through a combination of state-of-the-art technology, comprehensive training programs, and a supportive work culture, Leading Edge Connections empowers its remote agents to deliver outstanding performance and exceed client expectations. As the #1 virtual contact center in America, Leading Edge Connections has earned a reputation for its exceptional customer service, exceptional results, and industry-leading expertise. With a track record of success and a forward-thinking approach to remote work, Leading Edge Connections continues to revolutionize the contact center industry and set new standards for excellence

Company details

IndustryCustomer Experience & Contact Centers
Company size1001 - 5000

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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

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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