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Telephone triage nurses
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).
