Medical Insurance Denials & Appeals Coordinator – US Healthcare

This is a fully remote position, open to applicants in South Africa.

📋 Description

• Oversee medical insurance appeal cases from initiation to completion

• Prepare and submit documentation for insurance appeals related to denied claims

• Gather and arrange clinical and administrative documentation to support appeals

• Monitor appeals, submission deadlines, and follow-up schedules

• Communicate with US insurance companies to check the status of appeals and obtain necessary information

• Follow up on unresolved appeals to ensure prompt resolution

• Relay updates and outcomes of appeals to the billing team

• Request and acquire any outstanding documentation needed to strengthen appeals

• Keep precise records and case notes in internal systems

• Escalate urgent or time-sensitive issues as necessary

• Complete tasks accurately, professionally, and within the designated turnaround times

⛳️ Requirements

• At least 2 years of experience in medical billing, medical claims administration, medical aid administration, healthcare administration, hospital administration, or insurance claims administration

• Exceptional written and verbal communication skills in English

• Strong organizational abilities and time management skills

• Remarkable attention to detail

• Comfortable handling confidential patient information

• Confident in professional communication via phone and email

• Proficient in Microsoft Outlook and Microsoft Office applications

• Capable of working independently and managing multiple tasks

• A fixed fibre internet connection with a minimum of 25 Mbps upload and download speed and wired Ethernet capability is required

• Reliable power backup is essential

• Availability to work Monday through Friday, from 3:00 PM to 12:00 AM South African time, accommodating daylight saving time

• Must be available to work on South African and U.S. public holidays

• Experience in the US healthcare system, medical billing, or insurance claims is highly beneficial

• Previous experience in handling denied claims or insurance appeals is highly beneficial

• Knowledge of Revenue Cycle Management (RCM) is highly beneficial

• Experience in behavioral health, hospitals, or medical practices is highly beneficial

🏝️ Benefits

• Compensation for South African public holidays in accordance with the BCEA

• Fully remote work environment