Telephone triage nurses
Exclusively RemoteJob Description
Remote Nurse - High Volume Claims Call Specialist
Location: Remote (Work from Home)
Hours: Full-time, 3Pm-11pmSA (Monday Friday)
Must Reside in South Africa
Overview:
We are seeking a tech-savvy, highly communicative Nurse to join our team as a Claims Call Specialist. You will be responsible for conducting outbound calls to patients recently discharged from hospitals, assessing their post-discharge needs, discussing medication adherence, appointment scheduling, and related care.
All calls are processed through a sophisticated system that automatically records the conversation, generates tasks, applies billing codes, and prepares claims. The focus is on phone communication only no direct nursing or clinical tasks.
Key Responsibilities:
- Conduct high-volume outbound calls to patients discharged from medical facilities.
- Discuss topics such as medication management, follow-up appointments, and general well-being.
- Follow a structured call guide to capture specific information tied to billing codes.
- Meet productivity targets (aiming for 2-3 completed claims calls per hour).
- Ensure all conversations are clear, empathetic, and professional.
- Use the automated system effectively to ensure accurate task generation and billing preparation.
- Maintain confidentiality and adhere to HIPAA and privacy regulations.
Requirements:
- Active Nursing License (RN, LPN, or LVN) must be current and unrestricted.
- Excellent verbal communication and listening skills.
- Comfortable handling a high volume of structured calls (phone-based role).
- Tech-savvy; able to learn and operate call management and billing software.
- Ability to work independently, stay focused, and meet hourly call/claims targets.
- High attention to detail and strong organizational skills.
- Reliable internet connection, computer, and headset for remote work.
Preferred Experience:
- Previous experience in telehealth, care management, insurance claims, or call center environments is a plus.
- Familiarity with medical coding and billing is an advantage (not required).
Originally posted on Himalayas
