Medical Claims & Authorization Specialist
Affinity International
Remote, South Africa
Location: Remote – South Africa
Employment Type: Full-Time
Working Hours: US Eastern Time (EST/EDT) Business Hours
Company: US-Based Healthcare Organisation
Overview
We are recruiting on behalf of our client for a Medical Claims & Authorization Specialist to join a US-based healthcare organisation on a fully remote basis.
The role focuses on managing medical insurance claims, following up on outstanding payments, resolving claim denials, handling appeals, and ensuring timely reimbursement from insurance providers.
The successful candidate will have experience in medical billing, medical claims administration, or healthcare accounts receivable, with strong attention to detail and the ability to manage a high volume of accounts independently.
Full training on the company's systems, processes, and specific insurance providers will be provided.
Key Responsibilities
Follow up with insurance companies regarding unpaid, delayed, denied, and underpaid medical claims through telephone calls and online portals.
Review rejected and denied claims, identify reasons for non-payment, correct discrepancies, and arrange resubmissions.
Prepare and submit insurance appeals with the...
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