Medical Representative jobs in Sandton, Gauteng

Medical Benefits Verification Specialist
OVERVIEW
We are recruiting on behalf of our client for a Medical Benefits Verification Specialist. This is a fully remote position supporting a US-based healthcare client, with the successful candidate required to work aligned to Eastern Standard Time (EST) business hours. The specialist will be responsible for
verifying patients' insurance benefits and ensuring accurate coverage information is in place before services are rendered. This is an urgent hire. Candidates with direct Verification of Benefits (VOB) experience within a US
healthcare environment are strongly encouraged to apply.

KEY RESPONSIBILITIES
Verify patient insurance eligibility and benefits with US-based insurance providers prior to service
delivery
Contact insurance companies directly via phone and payer portals to confirm coverage details,
deductibles, co-pays, and out-of-pocket costs
Identify prior authorization requirements or coverage limitations and communicate these to the
relevant internal teams
Accurately document all verified benefits information within the client's designated system
Follow up on outstanding verifications to ensure no delays in patient service timelines
Liaise with internal teams to resolve discrepancies and ensure patient records are complete and
current
Manage a high volume of verification requests while maintaining a consistent standard of accuracy

REQUIREMENTS
Matric (Grade 12) as a minimum; a National Diploma or relevant NQF Level 6 qualification in
healthcare administration, medical billing, or a related field is advantageous
Demonstrated experience in Verification of Benefits (VOB) within a US healthcare environment
Solid understanding of US health insurance plans, insurance terminology, and payer portals
Experience verifying eligibility, authorizations, deductibles, co-pays, and out-of-pocket costs
Reliable home office setup with stable internet connectivity to support consistent remote work
Ability and willingness to work US Eastern Standard Time (EST) business hours

PREFERRED EXPERIENCE
Prior experience working remotely for a US-based healthcare or medical billing client
Familiarity with US payer portals such as Availity, NaviNet, or similar platforms
Experience in a high-volume verification or medical billing environment
Background in behavioral health, rehabilitation, or specialty healthcare settings