Remote Medical Claims Reviewer (Part-Time/Full-Time)

About the Role

100% remote. Flexible hours. Part or full-time. Review claims. Work from your couch. Actually have a life. Done.

Work-Life Balance Factors

Remote/telehealth

Key Responsibilities

• Maintain strict confidentiality and adhere to all data privacy regulations (e. g., GDPR, local Rwandan laws).
• Identify and report potential fraudulent claims or policy abuse to management.
• High level of integrity, ethical conduct, and commitment to patient confidentiality.

Requirements

• Required Skills
• Ability to work independently, manage time effectively, and meet deadlines in a remote work environment.
• Certification in medical coding (e. g., CPC, CCS) or claims adjudication.

Benefits & Compensation

• Communicate effectively with healthcare providers and members to resolve discrepancies and gather additional information.
• Participate in ongoing training and professional development to stay current with healthcare trends and policy changes.
• Proven experience as a Medical Claims Reviewer or in a similar role within healthcare or insurance.
• Strong understanding of medical terminology, CPT, ICD-10 coding, and healthcare billing practices.
• Bachelor's degree in Nursing, Health Administration, Business Administration, or a related field.
• Experience with Rwandan healthcare regulations and insurance frameworks.

Work Schedule

• Flexible part-time or full-time remote work options.