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Case Manager & Billing (USA Healthcare) - EST hours (Remote)

Case Manager & Billing (USA Healthcare) - EST hours (Remote)

ISTA SolutionsWorkFromHome, Limpopo, South Africa
30+ days ago
Job type
  • Remote
Job description

Overview

Case Manager & Billing (USA Healthcare) - EST hours (Remote)

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 Lead with USA experience .

Experience : This role requires a minimum of 1-year experience in the USA Healthcare Industry, with strong knowledge of medical billing (claims), initial authorization processing (In-patient) and case management (reviewing clinicals) and MS Office.

This role requires a minimum of 1-year experience in the USA Healthcare Industry, with strong knowledge of medical billing (claims), initial authorization processing (In-patient) and case management (reviewing clinicals) and MS Office.

Working information

  • Working Hours : This role requires you to work USA hours Mon - Fri from 9am to 6pm EST (15h00pm to midnight South African time). Hours are subject to change depending on daylight savings.
  • Work Environment : Remote
  • 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.
  • Power Backup : A reliable power backup solution is required to manage load shedding and power outages.

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 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 US healthcare settings, with a 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.

    Details

  • Seniority level : Entry level
  • Employment type : Full-time
  • Job function : Administrative
  • Industries : IT Services and IT Consulting
  • #J-18808-Ljbffr

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    Case Manager • WorkFromHome, Limpopo, South Africa

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