Claims Specialist

Holista

Claims Specialist resolving claims and authorizations for healthcare providers in a remote capacity. Handling incoming inquiries and ensuring accurate documentation for processing.

Posted 4/27/2026full-timeRemote • Arizona, Florida, Montana, Nevada, Texas, Washington, Wisconsin • 🇺🇸 United StatesJunior💰 $21 - $31 per hourWebsite

About the role

Key responsibilities & impact

Research and resolve all claims and authorizations exceptions using internal resources.
Provide communication to providers as necessary regarding the status of a claim or authorization.
Follow up with providers on all financial implications of reprocessed claims or authorizations.
Transport all claims entered by processors from image software to proprietary software for review.
Utilizing knowledge of system, research current queues of work to find claims requiring further research and correction.
Research and resolve any claim and authorization issues to determine best resolution.
Work with internal departments to resolve issues involving authorization or claim handling.
Recoup any overpayments to providers resulting from changes to a claim or authorization processing by posting to the provider account.
Log all claims and authorizations that cannot be resolved and send rejection letters to providers.
Using knowledge of authorizations, hold certain payments pending the outcome of client review.
Adjudicate claims and send for payments ensuring that all proper documentation is attached.
Complete daily audit of claims entered by Claim Intake representative.
Take any incoming calls from providers or members regarding authorizations, benefits, or claim status.
Provide backup to Accounts Receivable Assistant or Authorization Representative as needed.
Develop and/or communicate methods to improve productivity and efficiency.
Assist with gathering data for client audits.
Contribute to the team effort by accomplishing additional responsibilities as needed.
Assist with training of new staff members.

Requirements

What you’ll need

High school diploma or equivalent
1+ year(s) of general administrative or office experience.
Proficient in MS Office Word/Excel/Outlook.
Demonstrated Analytical and critical thinking skills.
Ability to prioritize and organize multiple tasks.
Ability to remain organized with multiple interruptions.
Ability to successfully communicate with clients.
Post secondary education in a related field.
3+ year(s) working with medical insurance/claim process.
Previous experience working in a remote environment.
Knowledge of health care and/or PT, OT, ST terminology, coding, and operations.

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Holista Website LinkedIn All Job Openings 11 - 50 employees Founded 2018 ⚕️ Healthcare Insurance ☁️ SaaS 🤝 B2B Healthcare Insurance
SaaS
B2B Holista is a healthcare company that delivers technology-enabled, value-based episodes of specialty care for employers, providers, brokers, and payers. It offers bundled, transparent pricing and care coordination to reduce costs, improve outcomes, and provide concierge-level patient support across specialties like orthopedics, maternity, imaging, and mental health. Holista combines clinical networks with a platform-driven experience to simplify benefits administration and care delivery. Claims Specialist Job not on LinkedIn 🔥 5 minutes ago 🌵 Arizona, Florida, +5 more states – Remote 💵 $20 - $30 / hour ⏰ Full Time 🟢 Junior 📋 Claims Specialist 🚫👨‍🎓 No degree required Apply Now Find Hiring Managers Customize resume for this job Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Research and resolve all claims and authorizations exceptions using internal resources.
Provide communication to providers as necessary regarding the status of a claim or authorization.
Follow up with providers on all financial implications of reprocessed claims or authorizations.
Transport all claims entered by processors from image software to proprietary software for review.
Utilizing knowledge of system, research current queues of work to find claims requiring further research and correction.
Research and resolve any claim and authorization issues to determine best resolution.
Work with internal departments to resolve issues involving authorization or claim handling.
Recoup any overpayments to providers resulting from changes to a claim or authorization processing by posting to the provider account.
Log all claims and authorizations that cannot be resolved and send rejection letters to providers.
Using knowledge of authorizations, hold certain payments pending the outcome of client review.
Adjudicate claims and send for payments ensuring that all proper documentation is attached.
Complete daily audit of claims entered by Claim Intake representative.
Take any incoming calls from providers or members regarding authorizations, benefits, or claim status.
Provide backup to Accounts Receivable Assistant or Authorization Representative as needed.
Develop and/or communicate methods to improve productivity and efficiency.
Assist with gathering data for client audits.
Contribute to the team effort by accomplishing additional responsibilities as needed.
Assist with training of new staff members. 🎯 Requirements
High school diploma or equivalent
1+ year(s) of general administrative or office experience.
Proficient in MS Office Word/Excel/Outlook.
Demonstrated Analytical and critical thinking skills.
Ability to prioritize and organize multiple tasks.
Ability to remain organized with multiple interruptions.
Ability to successfully communicate with clients.
Post secondary education in a related field.
3+ year(s) working with medical insurance/claim process.
Previous experience working in a remote environment.
Knowledge of health care and/or PT, OT, ST terminology, coding, and operations. Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Liability Claims Associate, NY or HI Licensing Required 🕒 Yesterday Sedgwick 10,000+ employees 🏢 Enterprise 📋 Compliance Website LinkedIn All Job Openings Analyze lower-level liability claims within Sedgwick’s standards. Collaborate to determine benefits due while maintaining professional client relationships. 🇺🇸 United States – Remote 💵 $24 / hour ⏰ Full Time 🟢 Junior 🟡 Mid-level 📋 Claims Specialist 🚫👨‍🎓 No degree required 🦅 H1B Visa Sponsor Claims Examiner 🕒 Yesterday Prudential Financial 10,000+ employees 💸 Finance 🏠 Real Estate Website LinkedIn All Job Openings Claims Examiner reviewing and processing death claims for OSGLI. Managing pending claims and corresponding with various parties throughout the claims process. 🇺🇸 United States – Remote 💵 $45.7k - $75.5k / year ⏰ Full Time 🟢 Junior 🟡 Mid-level 📋 Claims Specialist Insurance Claims Specialist 🕒 2 days ago WVU Medicine 10,000+ employees ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Insurance Claims Specialist managing patient account balances for WVU Medicine hospitals. Submitting claims, resolving issues, and ensuring compliance with billing regulations. 🇺🇸 United States – Remote ⏰ Full Time 🟢 Junior 📋 Claims Specialist 🚫👨‍🎓 No degree required Casualty Claims Adjuster I 🕒 3 days ago EMC Insurance Companies 1001 - 5000 Website LinkedIn All Job Openings Casualty Claims Adjuster I at EMC handling insurance claims, ensuring coverage and compliance. Initiating investigations and managing communications with insureds and claimants in a remote role. 🇺🇸 United States – Remote 💵 $55.8k - $77.1k / year ⏰ Full Time 🟢 Junior 📋 Claims Specialist Associate Mechanical Claims Adjuster 🕒 3 days ago Assurant 10,000+ employees 💸 Finance 👥 B2C Website LinkedIn All Job Openings Responsible for adjusting automotive claims by reviewing vehicle service agreements and resolving customer issues. Working remotely for Assurant's services to support connected products. 🇺🇸 United States – Remote 💵 $20 - $23 / hour 💰 Post-IPO Debt on 2023-02 ⏰ Full Time 🟢 Junior 🟡 Mid-level 📋 Claims Specialist 🚫👨‍🎓 No degree required 🦅 H1B Visa Sponsor View More Claims Specialist Jobs 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs

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Hard Skills & Tools

claims processingauthorization handlingdata analysisauditingmedical codingfinancial reconciliationdocumentation managementproblem resolutionadministrative supportoffice software proficiency

Soft Skills

analytical thinkingcritical thinkingorganizational skillscommunication skillsprioritizationteam collaborationtrainingadaptabilitytime managementcustomer service