Claims Specialist

ReWorks Solutions

Claims Specialist processing insurance claims with a focus on accuracy and compliance. Collaborating with teams to resolve issues while working remotely from South Africa.

Posted 4/28/2026full-timeRemote • 🇿🇦 South AfricaJuniorMid-LevelWebsite

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

Comfortable working U.S. hours
Remote work from home

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims processingmedical terminologyCPT codingICD-10 codingHCPCS codinginsurance policiesanalytical skillsattention to detail

Soft Skills

communication skillsverbal communicationwritten communicationindependent worktime management

Certifications

Associate's degreeBachelor's degree