[Hiring] Medical Insurance Denials & Claims Follow-Up Specialist @ReWorks Solutions

Role Description

We are seeking an organised, persistent, and detail-oriented Medical Insurance Denials & Claims Follow-Up Specialist to support a US-based healthcare operation. The successful candidate will be responsible for:

• Reviewing medical billing, outstanding claims, and insurance denial reports.
• Investigating denied, rejected, underpaid, or unpaid insurance claims.
• Contacting insurance companies to obtain claim updates and determine reasons for non-payment.
• Following up consistently on outstanding claims until resolution.
• Identifying the information or corrections required to resolve claim issues.
• Correcting and resubmitting claims where necessary.
• Maintaining accurate and detailed notes of all follow-up activities.
• Tracking claims throughout the resolution process.
• Identifying recurring denial trends or billing issues.
• Escalating complex or recurring issues when appropriate.
• Communicating claim updates clearly to relevant internal stakeholders.
• Ensuring outstanding items are followed through and not left unresolved.

Qualifications

• Previous medical billing, medical claims, health insurance, or revenue cycle experience is preferred.
• Experience working with US healthcare insurance would be advantageous.
• Strong organisational and administrative skills.
• Excellent attention to detail and accuracy.
• Confident and persistent when following up with insurance companies.
• Strong problem-solving and investigative skills.
• Professional and pleasant communication style.
• Ability to maintain detailed and accurate records.
• Strong written and verbal English communication skills.
• Ability to manage multiple outstanding claims and priorities simultaneously.
• Comfortable working independently with minimal supervision.
• Reliable follow-through and a strong sense of accountability.
• Comfortable working U.S. hours.

Requirements

• Remote work from home.

Benefits

• Full-Time, Work from Home.
• Hours: Monday to Friday: 9am- 5pm EST (US Hours).
• Salary: South African Rand (ZAR).

Fraud Disclaimer

ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.