Role Description Join Platinum Choice Healthcare as a Licensed Health Insurance Agent and take your career to the next level. We offer remote and in-office positions with comprehensive training and competitive compensation plans designed to reward your hard work and dedication. - Engage with clients to provide tailored health insurance solutions, focusing on hospital indemnity, cancer coverage, dental, home health care, and caregiver coverage. - Utilize live inbound leads to conduct needs analysis and guide clients through the application process. - Ensure compliance with industry regulations and company policies. - Maintain accurate records and use CRM tools to manage client interactions and sales activities. - Work collaboratively with team members and participate in ongoing training and coaching sessions. Qualifications - Active insurance license (2-40, 2-15, or equivalent in resident state). - Experience in health insurance sales preferred, especially with hospital indemnity and ancillary products. - Strong phone sales skills and ability to handle inbound leads professionally. - Knowledge of compliance and regulatory requirements. - Self-motivated, coachable, and committed to achieving sales targets. - Medicare sales experience is a plus but not required. - Ability to work remotely or in-office as required. Requirements - Work from home. - Make your own schedule. - You control how much you make a week. Benefits - Competitive hourly base pay and performance-based commissions. - Monthly bonus opportunities and uncapped earning potential. - Opportunity to earn $90K+ within the first year. - Be a part of a supportive and energetic team focused on delivering exceptional insurance products to clients while growing your income.

• Protects the financial standing of Optim Health by performing functions related to the billing, coding verification, collection, payment, and customer service for all payer and patient accounts. • Under general supervision, is responsible for processing insurance and billing insurance in a timely manner. • Reviews assigned electronic claims and submission reports. • Resolves and resubmits rejected claims appropriately as necessary. • Works closely with Medical Records, Coding, Revenue Integrity, Patient Access, and Patient Financial Services departments to resolve outstanding claim errors by obtaining necessary information for accurate billing. • Processes daily error logs, stalled reports, aging claims, and any ah-hoc reports. • Addresses claim issues from insurance companies requesting additional information and/or checking status of billings. • Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. • Initiates next billing, assign appropriate follow-up and/or collection step(s), this is not limited to calling patients, insurers or employers, as appropriate. • Sends initial or secondary bills to Insurance payers. • Documents billing, follow-up and/or assign collection step(s) that are taken and all measures to resolve assigned accounts, including escalation to Supervisor/Manager if necessary. • Processes administrative and Medical appeals, refunds, reinstatements and rejections of insurance claims with the oversight of the Supervisor and/or Manager.

• Planning and leading client meetings, walk-through reviews of clients control procedures and processes; delivery and presentation of client deliverables • Developing and leading the performance of, testing of clients’ security, privacy and other information risk management related controls • Directing the execution of testing of clients’ internal controls, testing of clients’ internal controls and review of internal control testing executed by other team members • Supporting clients in problem identification and resolution • Performing assessments and testing against leading information security and privacy standards and frameworks, including ISO 27001, Trust Services Criteria, PCI DSS, NIST CSF, GDPR, HITRUST and others • Leading and supporting preparation of client reporting deliverables; e.g., gap and risk assessments, SOC reporting, GDPR assessments, ISO 27001 certifications, etc.

Role Description - Manage and follow up on insurance authorisations, including SCA processes - Communicate with insurance providers to obtain approvals, updates, and required documentation - Track and maintain accurate records of authorisation statuses and deadlines - Conduct consistent follow-ups via phone and email to ensure timely processing - Assist with administrative tasks related to insurance and patient services - Identify and resolve issues or delays in the authorisation process - Coordinate with internal teams to ensure all required documentation is complete and accurate - Maintain organisation across systems and workflows Qualifications - Proven experience with insurance authorisations (SCA experience required) - Strong phone communication and follow-up skills - Highly responsive, organised, and detail-oriented - Resourceful with the ability to problem-solve independently - Comfortable being persistent and driving processes forward - Experience with CentralReach and/or Monday.com (preferred, not essential) - Ability to work independently with minimal supervision - Comfortable working U.S. hours Requirements - Remote work from home Benefits - Salary: Paid in South African Rand (ZAR) - Employment Type: Full-Time - Working Hours: US Hours (9am-5pm EST) Company Description Fraud Disclaimer: ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.