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:

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Conduct high-volume outbound calls to patients discharged from medical facilities.

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Discuss topics such as medication management, follow-up appointments, and general well-being.

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Follow a structured call guide to capture specific information tied to billing codes.

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Meet productivity targets (aiming for 2-3 completed claims calls per hour).

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Ensure all conversations are clear, empathetic, and professional.

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Use the automated system effectively to ensure accurate task generation and billing preparation.

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Maintain confidentiality and adhere to HIPAA and privacy regulations.

Requirements:

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Active Nursing License (RN, LPN, or LVN) must be current and unrestricted.

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Excellent verbal communication and listening skills.

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Comfortable handling a high volume of structured calls (phone-based role).

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Tech-savvy; able to learn and operate call management and billing software.

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Ability to work independently, stay focused, and meet hourly call/claims targets.

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High attention to detail and strong organizational skills.

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Reliable internet connection, computer, and headset for remote work.

Preferred Experience:

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Previous experience in telehealth, care management, insurance claims, or call center environments is a plus.

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Familiarity with medical coding and billing is an advantage (not required).

Originally posted on Himalayas