Remote Insurance Claims Specialist

Outcome Insurance Solutions; Conroe (TX); Remote; USD 38,000 - 56,000; Full time

Job summary

Outcome Insurance Solutions is seeking a detail-oriented Insurance Claims or Processing Specialist to support administrative and claims-processing activities. The role focuses on accurate record-keeping, document review, and timely processing in a remote environment.

Responsibilities include reviewing claims, updating systems, requesting missing information, and maintaining confidentiality while communicating with customers and insurers. Strong attention to detail and independence are essential.

Qualifications

• High school diploma or equivalent required.
• Experience in insurance claims or administration preferred.
• Strong attention to detail and organization.
• Clear written and verbal communication.
• Proficient with basic computer tools (email, spreadsheets, data-entry).
• Ability to manage multiple tasks and meet deadlines.
• Ability to handle sensitive information responsibly and maintain confidentiality.
• Willingness to learn company procedures and insurance-related systems.

Responsibilities

• Review claims and supporting documentation for completeness and accuracy.
• Enter and maintain claim and policy information in systems.
• Identify missing information and request corrections.
• Communicate professionally with customers and insurers.
• Track claim status and deadlines.
• Organize electronic files and maintain records.
• Follow confidentiality procedures.
• Escalate complex claims for review.
• Assist with routine reports and processing updates.
• Comply with insurance regulations and privacy requirements.

Skills

Attention to detail

Organizational skills

Written and verbal communication

Time management

Discretion / confidentiality

Remote work readiness

Education

High school diploma or equivalent

Tools

Insurance software

Job description

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.

Job Summary

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.

Key Responsibilities

• 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.

Qualifications

• 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.

Remote Work Requirements

• 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.