Insurance Research & Claims Specialist (Remote)

About the Company

About the Role

This position focuses on insurance research and claims management responsibilities. The ideal candidate will investigate U.S. insurance payer requirements, laws, and billing policies while managing Auto and Workers’ Compensation claims and suits someone analytical, persistent, and confident communicating with U.S.-based insurers and agencies.

Responsibilities

• Conduct research on insurance enrollment procedures, billing codes, and reimbursement policies for U.S. commercial and Medicaid payers
  

• Review and summarize state-specific laws affecting healthcare billing and claims
  

• Contact insurance representatives and government agencies to clarify details and gather missing information
  

• Maintain organized documentation and reports for the billing and credentialing teams
  

• Manage ongoing Auto and Work Comp claims, including coordinating with attorneys and collecting required medical records
  

• Follow up on rebills and claim updates via phone and online portals
  

• Ensure information accuracy and maintain confidentiality in line with U.S. healthcare compliance standards
  

Qualifications

• Excellent written and spoken English with a professional and confident phone manner
  

• Strong research and analytical skills, able to locate and verify information from multiple sources
  

• Detail-oriented, organized, and able to manage tasks independently in a remote environment
  

• Tech-savvy and comfortable navigating multiple online platforms and software tools
  

• Persistent and resourceful, able to handle follow-ups and problem-solving through calls and emails
  

• Prior experience in healthcare billing, insurance research, or claims processing is an added advantage
  

Work Schedule & Hours

• Full-time role
  

• Must be available during U.S. business hours (7 a.m.– 6 p.m. CST) for calls, team meetings, and follow-ups
  

Technical Requirements

• Reliable computer (less than 3 years old) with Windows 11 Pro or MacOS Sequoia 15.6 or newer operating system.
  

• Stable and secure internet connection suitable for video calls and research
  

• Quality headset for calls and Zoom meetings
  

• Updated cybersecurity software
  

• Smartphone for two-factor authentication and communication