Medical Insurance Denials & Claims Follow-Up Specialist

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

📋 Description

• Analyze medical billing, outstanding claims, and reports on insurance denials.

• Examine denied, rejected, underpaid, or unpaid insurance claims.

• Reach out to insurance companies to acquire updates on claims and ascertain reasons for non-payment.

• Consistently follow up on outstanding claims until a resolution is achieved.

• Identify necessary information or corrections to address claim issues.

• Amend and resubmit claims when needed.

• Keep precise and comprehensive records of all follow-up efforts.

• Monitor claims throughout the resolution process.

• Detect recurring trends in denials or billing problems.

• Escalate complex or persistent issues as needed.

• Clearly communicate claim updates to relevant internal stakeholders.

• Ensure that all outstanding items are addressed and not left unresolved.

⛳️ Requirements

• Prior experience in medical billing, medical claims, health insurance, or revenue cycle is preferred.

• Familiarity with U.S. healthcare insurance is advantageous.

• Strong organizational and administrative capabilities.

• Exceptional attention to detail and accuracy.

• Confident and diligent in following up with insurance companies.

• Strong analytical and investigative abilities.

• Professional and friendly communication style.

• Ability to maintain detailed and accurate records.

• Proficient in written and verbal English communication skills.

• Capability to manage multiple outstanding claims and priorities at once.

• Comfortable working independently with minimal supervision.

• Reliable follow-through and a strong sense of accountability.

🏝️ Benefits

• Comfortable working U.S. hours

• Remote work from home