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).