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Claim specialist
Job Location:
Job Location:
Barranquilla - Colombia
Monthly Salary:
Not provided by the employer
Monthly Salary:
Experience Required:
0-1years
Experience Required:
Posted:
27 May 2026 (30+ days ago)
Posted:
Application Deadline:
24 August 2026
Application Deadline:
Vacancies:
1 Vacancy
Vacancies:
Job Summary
We are seeking a highly motivated and productivity-driven Claims Follow-Up Representative to join our team. This role focuses exclusively on managing and resolving out-of-network (OON) commercial insurance claims. You will be responsible for directly contacting insurance payers to investigate claim statuses appeal denials and optimize overall workflow efficiency. This position requires high-volume phone outreach and meticulous electronic documentation.
Key Responsibilities
- High-Volume Claim Management: Manage review and work a strict minimum of 75 commercial insurance claims per day.
- Direct Payer Contact: Conduct phone calls for every single claim to resolve issues directly with insurance payers; portal-only research is insufficient.
- Denial Tracking & Escalations: Identify high-dollar claims for prioritization and follow standard protocols for denial follow-ups and payer escalations.
- Data Documentation: Maintain flawless real-time documentation of claim actions within our EMR system and shared spreadsheets.
- Medical Records Assembly: Compile necessary medical records for insurance requests ensuring no records are sent to payers without internal review and consent.
Requirements
Required Skills:
Industry Experience: Minimum 6m - 2 years of experience focusing specifically on out-of-network (OON) commercial insurance claims follow-up. Communication Skills: Excellent verbal communication skills with a proven track record of handling high-volume professional phone outreach to insurance payers. Technical Proficiency: Hands-on experience navigating Electronic Medical Record (EMR) systems and working with shared spreadsheets (Excel/Google/Zoho Sheets). Efficiency: Proven ability to meet strict daily performance quality and productivity metrics. Attention to Detail: Sharp organizational skills required for capturing claim reference numbers and assembling medical record packages accurately.
