Claims Specialist – Accident and Health

About This Claims Specialist – Accident and Health Role

QBE Insurance is hiring for a Claims Specialist – Accident and Health position connected to Remote / Hybrid ### Eligible Locations * Marblehead, Massachusetts * Atlanta, Georgia ## Employment Type Full-Time ## Category Insurance ## Subcategory Accident & Health Claims ## Additional Categories * Insurance Claims * Health Insurance * Accident Insurance * Claims Management * Claims Investigation * Claims Settlement ## Phone Level Moderate Phone ## Job Summary QBE is seeking a Claims Specialist – Accident and Health to manage complex accident and health insurance claims. This position is responsible for reviewing policy coverage, investigating claims, evaluating liability, negotiating settlements, managing claim costs, and maintaining strong relationships with policyholders, agents, and service providers.. This Bellencia Career Hub summary translates the original job posting into a structured, easier-to-scan career lead for job seekers comparing remote, hybrid, back-office, healthcare, billing, and administrative opportunities.

The role appears to focus on accurate account work, structured documentation, research, and timely follow-through. Candidates should review the official posting carefully before applying because employer needs, schedules, location rules, and application requirements can change.

Key Responsibilities

Daily Work You May Handle

• Manage accident and health insurance claims
• Review policy coverage and claim eligibility
• Investigate claim details and supporting documentation
• Evaluate claims and determine appropriate resolution
• Negotiate claim settlements
• Communicate with policyholders, agents, and service providers
• Monitor claim costs and leakage
• Maintain claim documentation and records
• Respond to customer inquiries
• Identify and resolve claim issues

The core workflow centers on accuracy, research, and keeping accounts or records moving through the correct process. A strong applicant should be comfortable reviewing details, comparing information across systems, updating records, and documenting outcomes in a way that supports clean handoffs between departments.

Minimum Requirements

Education, Experience, and Technical Knowledge

• Required
• Relevant insurance experience
• Strong analytical skills
• Problem-solving skills
• Customer service skills
• Negotiation skills
• Communication skills
• Ability to manage multiple priorities

For this type of role, employers often look for a mix of practical experience, system confidence, and the ability to understand payer, billing, account, or documentation rules. Even when the role is not heavily phone-based, communication still matters because the work may involve coordination with internal teams, management, or partner departments.

Phone Level and Work Style

Bellencia phone-level estimate: Moderate phone. This classification is based on the wording in the pasted posting. Because this is an estimate, applicants who need non-phone or low-phone work should confirm phone expectations during the interview. The posting reads most strongly as Revenue Cycle work with a focus on written records, account review, payer details, research, and follow-up.

Pay, Schedule, and Location Details

Pay: not listed in the pasted posting. Schedule: not clearly listed. Job type: Full-time. Location or work arrangement: Remote / Hybrid ### Eligible Locations * Marblehead, Massachusetts * Atlanta, Georgia ## Employment Type Full-Time ## Category Insurance ## Subcategory Accident & Health Claims ## Additional Categories * Insurance Claims * Health Insurance * Accident Insurance * Claims Management * Claims Investigation * Claims Settlement ## Phone Level Moderate Phone ## Job Summary QBE is seeking a Claims Specialist – Accident and Health to manage complex accident and health insurance claims. This position is responsible for reviewing policy coverage, investigating claims, evaluating liability, negotiating settlements, managing claim costs, and maintaining strong relationships with policyholders, agents, and service providers.. Applicants should verify the official application page for the most current pay range, benefits, shift expectations, equipment rules, and state eligibility requirements.

Best-Fit Applicant Profile

This role may be a good match for someone who enjoys detailed, process-driven work and can stay consistent with repetitive but important tasks. It may fit job seekers with experience in medical billing, revenue cycle, accounts receivable, claims, refunds, charge capture, payer research, payment posting, documentation review, insurance eligibility, or healthcare administrative support.

• You are comfortable researching account details and correcting issues before they become larger problems.
• You can follow written procedures and keep documentation clean, accurate, and audit-ready.
• You prefer structured back-office work over sales-driven or heavy call-center duties.
• You can manage confidential information professionally and escalate unclear issues when needed.

Resume Keywords to Consider

Relevant resume keywords may include Claims Specialist – Accident and Health, Medical / Healthcare, Revenue Cycle, Medical Billing, Payment Posting, Insurance Verification, Coding, Refund Processing, Revenue Integrity, documentation, account research, workflow queues, Excel, payer requirements, reconciliation. Use only the keywords that honestly match your experience. The strongest applications usually connect past duties directly to the employer’s listed responsibilities.

How to Apply

Use the official application link for this job posting when you are ready to apply. Before submitting, review the required experience, confirm the schedule, and tailor your resume summary and bullet points toward the highest-priority duties in this listing.