ABA Insurance Verifications & QA Specialist | USA Hours | Remote

ISTA Personnel Solutions; Gauteng; Remote; ZAR 300,000 - 540,000; Full time

Job summary

ISTA Personnel Solutions in South Africa is recruiting an ABA Insurance Verifications & QA Specialist for a fully remote back-office role serving a U.S.-based paediatric therapy centre. You will verify out-of-network benefits, manage authorisations and QA session notes across platforms, supporting a small in-office team as needed.

Ideal candidates have ABA industry experience, comfort speaking with US insurers, and strong Microsoft 365 skills.

Qualifications

• ABA industry experience; not necessarily in billing/QA—administrative exposure is okay
• Comfortable communicating with US insurers via telecom
• Excellent written and spoken English

Responsibilities

• Verify out-of-network benefits with US insurers across all services
• Record benefits accurately on the board and manage authorisations
• Send patient responsibility contracts and follow up until signed
• Load real or placeholder authorisations into CentralReach for billing
• Review or re-verify client benefits in January when plans reset
• Assist with authorisation utilisation checks and timesheet issues

Skills

ABA experience

US insurer communications

English proficiency

Attention to detail

Proactive communication

Tools

CentralReach

Monday.com

NoteGuard AI

Microsoft Outlook

Microsoft Excel

Job description

ISTA Personnel Solutions is a dynamic and fast-growing BPO company. We are not a recruitment agency. We partner with international US clients and integrate our staff members directly within our clients' operations. We focus on long-term placements where you contribute directly to the client's success.

We are partnering with a U.S.-based, out-of-network paediatric therapy centre offering ABA, occupational therapy, speech and language and related services, to recruit an ABA Insurance Verifications & QA Specialist.

This is a fully remote, back-office role for a confident, proactive and detail-focused individual who enjoys thinking on their feet and keeping things accurate. You will support a small in-office team by verifying out-of-network insurance benefits, managing authorisations and reviewing session notes. The role is not staff-facing at first, but the client would like to grow it into staff-facing work once you have settled in.

PLEASE NOTE:

• Working hours: Monday to Friday, 16:00–01:00 SAST (subject to US daylight saving changes)
• Public Holidays: You will be required towork on both South African and U.S.public holidays(compensation for SA public holidays in accordance with the BCEA).
• Internet Requirements:A fixed fibre line with a minimum speed of25 Mbps (upload & download)and the ability to support awired Ethernet connectionis mandatory. Applicants without a fixed fibre line cannot be considered.
• Power Backup:Areliable power backup solutionis required to manage load shedding and power outages. Applicants without a power backup cannot be considered.
• Work Environment:This is afully remoteworking role and you must be based in South Africa.

Job Responsibilities (but not limited to):

• Pick up benefit checks from the Monday.com board for new enquiries and existing clients who change insurance
• Call US insurers to verify out-of-network benefits across all services, including coverage or exclusions, visit limits, deductibles, co-insurance and maximum out-of-pocket
• Record benefits accurately on the board
• Send patient responsibility contracts to parents once the payment plan has been agreed, and follow up until they are signed and returned
• Load real or placeholder authorisations into CentralReach so therapists can bill
• Extend or renew all authorisations before January, then re-verify every client’s benefits in the first two weeks of January when most plans reset
• Review flagged session notes in CentralReach and NoteGuard AI
• Check that amendment notes have been signed, then clear the label so sessions can move to payroll
• Resolve rule flags internally where possible (for example, data entered on the wrong day) and escape to therapists where needed
• Over time, support authorisation utilisation checks, timesheet authorisation issues and follow-up on unconverted timesheets

• ABA industry experience, with a solid understanding of the terminology (timesheets, goals, session notes, QA and authorisations). This does not need to be in billing or QA - ABA recruiting, onboarding or admin experience is sufficient
• Comfortable speaking with US insurers via telecom
• Proficiency in Microsoft 365, including Outlook and Excel
• Excellent written and spoken English
• Strong attention to detail and accuracy
• The initiative to question anything that looks off, rather than simply following the workflow
• The habit of communicating fully and proactively, giving real updates rather than one-word answers
• A confident, personable manner and an easy way of working with others

Beneficial Experience

• CentralReach experience
• Monday.com experience
• US health insurance or benefits verification experience, ideally across ABA, OT and speech
• Experience working with US or international clients
• Creative thinker, takes initiative, discusses ideas, asks questions and communicates effectively
• Friendly, pleasant and forthcoming personality