Medical Insurance Denials & Claims Follow-Up Specialist

🔥 3 minutes ago

🇿🇦 South Africa – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔒 Insurance

👻 Ghost score 25%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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ReWorks Solutions

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2024

🏥 Healthcare

📦 Logistics

📣 Marketing

Healthcare • Logistics • Marketing

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

• Review medical billing, outstanding claims, and insurance denial reports. • Investigate denied, rejected, underpaid, or unpaid insurance claims. • Contact insurance companies to obtain claim updates and determine reasons for non-payment. • Follow up consistently on outstanding claims until resolution. • Identify the information or corrections required to resolve claim issues. • Correct and resubmit claims where necessary. • Maintain accurate and detailed notes of all follow-up activities. • Track claims throughout the resolution process. • Identify recurring denial trends or billing issues. • Escalate complex or recurring issues when appropriate. • Communicate claim updates clearly to relevant internal stakeholders. • Ensure outstanding items are followed through and not left unresolved.

🎯 Requirements

• 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.

🏖️ Benefits

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