Roles & Skills
ECLARO places top-tier Insurance Submissions Clearance Specialists for all insurance lines and organizational levels — tailored to your business needs.
Junior Submissions Clearance Specialist
Assists in reviewing and preparing insurance submissions, verifying documentation completeness, and escalating discrepancies to senior team members.
Mid-Level Submissions Clearance Specialist
Handles complex submission packages, collaborates with underwriters and brokers, ensures regulatory and data accuracy, and coordinates follow-up requests.
Senior Submissions Clearance Specialist
Oversees submission intake processes end-to-end, mentors team members, develops clearance protocols, ensures SLA compliance, and collaborates cross-departmentally to optimize throughput.
Key skills
- Insurance policy knowledge and compliance expertise
- Document review and verification accuracy
- Claims processing and submission procedures
- Attention to detail and quality assurance
- Medical records interpretation and coding
- Regulatory compliance (state/federal insurance requirements)
- Communication and stakeholder coordination
Frequently asked questions
What does an Insurance Submissions Clearance Specialist do day-to-day?
This role focuses on reviewing, validating, and clearing insurance submissions before they reach carriers or regulators. Daily tasks include examining claim documents for accuracy and completeness, verifying that all required forms and supporting documentation are present, flagging discrepancies or missing information, coordinating with internal teams to resolve issues, and ensuring submissions comply with state and federal insurance regulations. Specialists work to reduce submission errors, improve approval rates, and accelerate the clearance timeline.
What qualifications or certifications are typically required?
Most positions require a high school diploma or GED; many employers prefer some professional experience in insurance, claims, or healthcare administration. Common certifications that strengthen candidacy include the Certified Insurance Customer Service Representative (CICSR), insurance license (Property & Casualty or Health), medical coding credentials (like CPC or CPHQ), or compliance certifications. Familiarity with insurance management software and strong knowledge of submission requirements across different insurance products (health, disability, liability) are highly valued.
How does hiring through a staffing firm like ECLARO work?
ECLARO manages the entire recruitment process: we identify qualified candidates with the specific expertise your company needs, conduct initial screening and interviews, handle background checks and verification, and place them as either full-time employees or contract workers based on your timeline and project scope. We manage compliance and payroll for contract placements, so you can focus on integration and project execution. Our specialists understand insurance workflows, so we match candidates who can contribute from day one.
What are the key responsibilities in this role?
Core responsibilities include reviewing insurance submission packages for completeness and accuracy, validating that all attachments (forms, medical records, authorizations) are present and legible, confirming compliance with state and federal regulations and carrier requirements, identifying and escalating submission errors or missing documentation, communicating status updates to internal stakeholders, maintaining submission logs and audit trails, and contributing to continuous improvement in submission quality and turnaround time. The role requires strong organizational skills and the ability to work independently while meeting strict deadlines.
Ways to hire through ECLARO
ECLARO can fill this role through contract or contract-to-hire staffing, direct placement, an Employer of Record (EOR), recruitment process outsourcing (RPO), or a dedicated offshore team in the Philippines (ECAPTIVE).