Offer summary

Qualifications:

Minimum of 1 year of experience in leading/managing a team in medical billing and case management., Strong knowledge of medical coding (CPT, ICD-10) and HIPAA regulations., Excellent communication, problem-solving, and organizational skills are essential., Detail-oriented with strong analytical skills and good judgment..

Key responsabilities:

Manage healthcare accounts and ensure seamless claims processing and authorizations.

Oversee accurate medical billing processes and coding for services.

Coordinate case management by reviewing clinicals and following up on claims.

Liaise with insurance providers to resolve denials and support patient care and billing processes.

Job description

ISTA Personnel Solutions South Africa - we are a global BPO company, partnering with a USA-based client offering Billing and Accounts Receivable Management Services in the Healthcare Sector, and are seeking a Healthcare Case Manager | Billing Manager.

PLEASE NOTE:

Working Hours: This role requires you to work USA hours Mon - Fri from 9am to 6pm EST (15h00pm to midnight South African time. These working hours are subject to change depending on daylight savings and /or the operational requirements of the company.)
Work Environment: This is a remote role for South African Citizens only.
Internet Requirements: A fixed fibre line with a minimum speed of 25 Mbps (upload & download) and the ability to support a wired Ethernet connection is mandatory. Applicants without a fixed fibre line cannot be considered.
Power Backup: A reliable power backup solution is required to manage load shedding and power outages. Applicants without a power backup cannot be considered.

Key Responsibilities:

Manage healthcare accounts, ensuring seamless claims processing and authorizations.
Oversee accurate and timely medical billing processes, including coding for services
Review clinicals for case management and coordinate approvals.
Follow up on claims, resolve denials, and liaise with insurance providers.
Work closely with clinical, administrative, and financial teams to support seamless patient care and billing processes.
Utilize MS Office (Excel, PDF, Outlook) for reporting and documentation.
Ensure compliance with billing policies and healthcare regulations.

Requirements

Minimum of 1 year of experience in leading/managing a team, with a strong focus on medical billing, coding (CPT, ICD-10), and case management.
Sound knowledge of HIPAA regulations.
Strong analytical skills and good judgment
Highly detail-oriented and precise
Efficient in managing and prioritizing emails
Excellent communication, problem-solving, and organizational abilities
Follows established processes with accuracy
Understands processes with the ability to exercise good judgement in taking appropriate next steps

If you are not contacted within 14 working days, please consider your application unsuccessful.

Required profile