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

ISTA Personnel Solutions; United States; Remote; USD 50,000 - 70,000; Full time

Job summary

ISTA Personnel Solutions is seeking a Healthcare Case Manager & Billing Lead with a minimum of 1 year of US healthcare experience. This role involves managing medical billing processes, overseeing claims and authorizations, and requires strong knowledge of HIPAA regulations. The position is remote, catering specifically to South African citizens, and involves working USA hours.

Qualifications

• Minimum 1 year in US healthcare industry with medical billing focus.
• Strong knowledge of HIPAA regulations.
• Detail-oriented and precise in managing processes.

Responsibilities

• Manage healthcare accounts and ensure seamless claims processing.
• Oversee medical billing processes and review clinicals.
• Coordinate with teams to support patient care and billing.

Skills

Medical billing

Case management

Analytical skills

Attention to detail

Problem-solving

Communication

Tools

MS Office

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 Lead with USA 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.

**** PLEASE DO NOT APPLY IF YOU DO NOT HAVE HEALTHCARE EXPERIENCE - YOU WILL NOT BE CONSIDERED!! ****

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, however these hours are subject to change depending on daylight savings).
• 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.

• Minimum of 1 year of experience in US healthcare settings, 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.