Job description:
Before You Apply

This position is 100% on-site in Barranquilla, Colombia.

About the Role

Venture Integral Solutions is hiring an experienced Claims Follow-Up Representative to independently manage, track, and resolve Out-of-Network (OON) commercial insurance claims for U.S.based healthcare providers.

Key Responsibilities
- Manage a daily minimum of 75 OON commercial insurance claims independently
- Conduct high-volume outbound calls directly to U.S. insurance payers to investigate statuses, dispute denials, and escalate unresolved claims
- Identify denial patterns, submit formal appeals, and follow escalation protocols to maximize reimbursement
- Maintain real-time, flawless documentation of all claim actions, reference numbers, and payer responses in EMR and shared spreadsheets




- Compile and submit complete medical record packages for appeals and audits, ensuring internal review prior to submission

Requirements (All items are mandatory)
- Minimum 1 year of direct, hands-on experience in Out-of-Network (OON) commercial insurance claims follow-up (not general billing or customer service)
- Proven experience in denial management, payer communications, and claims appeals in a U.S. healthcare context
- Ability to work independently and meet strict daily KPIs:
- Proficiency with EMR systems (NextGen experience is a plus but not required)
- Advanced use of Excel or Google Sheets for claims tracking
- Excellent spoken and written English

Work Location: In person

📌 Claims Specialist (Barranquilla)
🏢 Venture Global Solutions
📍 Barranquilla