Case Manager (Skilled Nursing Facilities) - Est Hours (Remote)

Ista Solutions; Gauteng; Remote; ZAR 300 000 - 400 000; Full time

Job summary

A global BPO company is seeking an Entry-Level Case Manager with experience in Skilled Nursing Facilities. This remote role focuses on medical billing, claims processing, and case management. Candidates must have at least 1 year of experience in the US healthcare sector and strong knowledge of HIPAA regulations. Essential skills include attention to detail and effective communication. The position requires working USA hours from South Africa.

Benefits

Remote work opportunity

Flexible working hours

Qualifications

• Minimum of 1 year of experience in US healthcare settings focusing on medical billing and case management.
• Sound knowledge of HIPAA regulations.
• Strong analytical skills and good judgment.

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.

Skills

Medical billing knowledge

Case management experience

Analytical skills

Attention to detail

Communication skills

Tools

MS Office (Excel, PDF, Outlook)

Job description

Case Manager (Skilled Nursing Facilities) - EST hours (Remote)

STA 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 Case Manager with Skilled Nursing Facilities 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.

Working Hours: This role requires you to work USA hours Mon - Fri from 9am to 6pm EST (15h00pm to midnight South Africa time, however these hours are subject to change depending on daylight savings).

Work Environment: This is a remote working role

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 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.

Seniority level

Entry level

Employment type

Full-time

Job function

Administrative

Industries

IT Services and IT Consulting