Remote Insurance Claims Specialist

Outcome Insurance Solutions is seeking a detail-oriented and organized Insurance Claims or Processing Specialist to support insurance-related administrative and claims-processing activities. The successful candidate will help maintain accurate records review documentation communicate with relevant parties and support timely processing in accordance with company procedures and applicable requirements.

The Insurance Claims or Processing Specialist will assist with reviewing insurance documents organizing claim information verifying the completeness of submitted materials updating records and following up on outstanding documentation. This position requires strong attention to detail confidentiality communication skills and the ability to work independently in a remote environment.

• Review insurance claims forms and supporting documentation for completeness and accuracy.

• Enter update and maintain claim and policy information in company systems.

• Identify missing information discrepancies or incomplete documentation and request corrections when appropriate.

• Communicate professionally with customers insurance representatives providers and internal team members as authorized.

• Track claim status processing deadlines follow-up requests and outstanding documents.

• Organize electronic files and maintain accurate records in accordance with company policies.

• Follow established procedures for handling confidential customer and insurance information.

• Escalate complex claims potential errors and issues requiring additional review to the appropriate team member.

• Assist with preparing routine reports and processing updates.

• Follow applicable insurance regulations privacy requirements and company policies.

• High school diploma or equivalent required.

• Previous experience in insurance claims insurance administration claims processing or a related office-support role is preferred.

• Strong attention to detail and organizational skills.

• Clear written and verbal communication skills.

• Basic computer proficiency including email spreadsheets and online data-entry systems.

• Ability to manage multiple tasks meet deadlines and work independently.

• Ability to handle sensitive information responsibly and maintain confidentiality.

• Willingness to learn company procedures and insurance-related systems.

Preferred qualifications:

• Experience with insurance claims management or policy administration software.

• Familiarity with insurance terminology and claims documentation.

• Relevant insurance certifications or licenses if applicable to the assigned duties.

• Reliable internet connection and a suitable workspace.

• Access to a computer and the technology required for the position as specified by the employer.

• Ability to participate in virtual meetings and communicate with the team during scheduled working hours.

• Ability to follow secure data-handling practices when working remotely.

Required Skills:

Data Entry Negotiation Customer Service Claims Investigation