US Insurance Claims Specialist

4 hours ago

Manila, National Capital Region, Philippines Magic Full time ₱3,600,000 - ₱4,800,000 per year

About the Client

A roofing and home-services contractor headquartered in Florida with 30+ years of experience serving homeowners across Northeast Florida and the Orlando area. They provide roof repairs, replacements, inspections, and insurance claim assistance with an emphasis on licensed, quality workmanship and customer service. They operate regionally across multiple Florida locations and offer 24/7 support and free, no-obligation roof inspections.

Why does this role exist?

This role is being hired to bring insurance billing and claims expertise into the accounting team so final invoicing, auditing, and carrier reconciliation are handled accurately and efficiently. The immediate objective is to validate job files and produce correct final invoices for insurers and homeowners, reduce billing exceptions and denials, and speed cash collection. Over time the position will grow into a broader insurance-billing/claims function as processes move fully into accounting.

Tasks and Responsibilities

Invoice preparation & auditing

  • Review JobNimbus job files, estimates, scopes, photos, and inspection reports to prepare final invoices.
  • Audit quantities (squares, linear footage), materials, labor, permits, and line items to ensure billable items are captured and priced correctly.
  • Validate documentation and flag missing or inconsistent items before invoicing.

Carrier & homeowner billing & follow-up

  • Create and submit final invoices to insurance carriers and homeowners according to carrier requirements.
  • Follow up on submitted invoices, track status, and escalate outstanding submissions as needed.
  • Manage supplements, resubmissions and reopenings with carriers.

Reconciliation & accounting support

  • Reconcile insurance payments, adjustments, and denials to invoices; post or coordinate postings into QuickBooks.
  • Work with the Accounts Receivable specialist to ensure payments are applied correctly and aged receivables are reduced.
  • Research and resolve underpayments, short pays, and payment discrepancies.

Claims documentation & compliance

  • Maintain accurate, auditable claim files that meet company and insurer documentation standards.
  • Ensure photos, inspection reports, estimates and scopes are retained and organized for audits.
  • Document all communications and follow-up actions on claim files.

Cross-functional coordination & reporting

  • Coordinate with production, field staff, project managers, and inspection teams to obtain missing documentation and clarify charges.
  • Provide timely status updates and reports to the Accounting Manager and AR lead.
  • Suggest process improvements to reduce rework and billing errors.

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