Claims Processor – Remote Insurance Specialist

About the role

We are seeking a detail‑oriented Claims Processor Specialist to review, verify and process insurance claims, ensuring coverage eligibility and compliance with company and regulatory guidelines. The role serves as the primary liaison between policyholders, insurance agents and providers, handling documentation and payments remotely.

Key responsibilities

• Review and process insurance claims accurately and promptly, verifying documentation for completeness and eligibility.
• Communicate virtually with claimants, agents and other stakeholders to request additional information or clarify details.
• Evaluate claim validity and recommend approval, denial or escalation, while flagging potential fraud or inconsistencies.
• Maintain detailed electronic records of processing activities and decisions.
• Collaborate with internal teams remotely to resolve complex claims and ensure adherence to policies, regulations and service standards.
• Generate reports and summaries to track claim volumes, trends and outcomes.

Required profile

• Bachelor’s degree in Business, Finance, Insurance or a related field.
• 3‑5 years of experience in claims processing and insurance.
• Strong understanding of insurance policies, regulations and claims procedures.
• Excellent analytical, problem‑solving and decision‑making abilities.
• Effective written and verbal communication skills suitable for remote work.
• Reliable high‑speed internet connection, working laptop and backup power source.

Required skills

• Proficiency with claims management software.
• Proficiency with Microsoft Office Suite.