Claims Specialist

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ReWorks Solutions

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2024

🎯 Recruiter

🤝 B2B

Recruitment • B2B

ReWorks Solutions is a premium remote staffing company that provides rigorously vetted, native English-speaking offshore professionals from South Africa and the Philippines, managed end-to-end with white-glove onboarding, continuous coaching, performance monitoring, and HIPAA-compliant processes. They position themselves as a B2B partner for healthcare organizations and other businesses seeking client-facing and backend remote teams, promising cost savings, high retention, and compliance. ReWorks combines hands-on team management with AI-powered support to streamline hiring, scaling, and ongoing oversight of remote staff.

📋 Description

• Process and adjudicate insurance claims according to company policies and regulations, ensuring accuracy and compliance. • Review and analyze claims to identify any discrepancies or issues requiring resolution. • Communicate with insurance companies, healthcare providers, and patients to address claims-related inquiries and disputes. • Collaborate with internal teams to gather necessary documentation and information to support claim decisions. • Maintain detailed records of claims activity and ensure timely follow-up on outstanding claims. • Stay updated on industry changes and payer policies to optimize claims processing and reimbursement rates.

🎯 Requirements

• Associate's degree in healthcare administration, business, or a related field; Bachelor's degree preferred. • Minimum of 2 years of experience in claims processing or a related role in the healthcare industry. • Strong understanding of medical terminology, coding (CPT, ICD-10, HCPCS), and insurance policies. • Excellent analytical skills with keen attention to detail. • Proficient in claims management software and electronic health record (EHR) systems. • Strong communication skills, both verbal and written, for effective interaction with stakeholders. • Able to work independently in a remote setting and manage time effectively to meet deadlines.

🏖️ Benefits

• Comfortable working U.S. hours • Remote work from home