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 authorizationsOversee accurate and timely medical billing processes, including coding for servicesReview clinicals for case management and coordinate approvalsFollow up on claims, resolve denials, and liaise with insurance providersWork closely with clinical, administrative, and financial teams to support patient care and billing processesUtilize MS Office (Excel, PDF, Outlook) for reporting and documentationEnsure compliance with billing policies and healthcare regulationsRequirements
Minimum of 1 year of experience in US healthcare settings, with a focus on medical billing, coding (CPT, ICD-10), and case managementSound knowledge of HIPAA regulationsStrong analytical skills and good judgmentHighly detail-oriented and preciseEfficient in managing and prioritizing emailsExcellent communication, problem-solving, and organizational abilitiesFollows established processes with accuracyUnderstands processes with the ability to exercise good judgement in taking appropriate next stepsIf you are not contacted within 14 working days, please consider your application unsuccessful.
Details
Seniority level : Entry levelEmployment type : Full-timeJob function : AdministrativeIndustries : IT Services and IT Consulting#J-18808-Ljbffr