Healthcare Case Manager – Managed Care & Billing

Dante Personnel Recruitment; South Africa; Remote; ZAR 360,000 - 600,000; Full time

Benefits offered by this job

Health insurance

Professional development

Career advancement

Paid time off

Job summary

Dante Personnel Recruitment is seeking a Remote Medical Billing and Coding Specialist to join a leading healthcare solutions provider. Remote role with a focus on accurate ICD-10-CM/CPT/HCPCS coding, claims submission, and compliance across SA regions.

You’ll work with physicians and insurers to ensure timely reimbursements while maintaining HIPAA-compliant documentation. Ideal candidates have 3+ years in medical billing and coding, CPC or CCS certification, experience with EHR systems, and a

Qualifications

• High school diploma or equivalent; associate/bachelor preferred.
• Certification from a recognized coding body (CPC or CCS).
• Minimum of 3 years of experience in medical billing and coding across various specialties.
• Knowledge of medical terminology, anatomy, physiology, and disease processes.
• Proficiency with EHR systems and medical billing software.
• Strong understanding of insurance billing and reimbursement procedures.
• Excellent analytical, problem-solving, and critical-thinking skills.
• Ability to work independently with minimal supervision.

Responsibilities

• Accurately assign ICD-10-CM, CPT, and HCPCS codes based on medical documentation.
• Review patient charts and medical records for coding accuracy.
• Submit insurance claims electronically and manually, follow up on status and denials.
• Communicate with physicians, providers, and insurers to clarify information.
• Stay up-to-date with coding guidelines, laws, and regulations.
• Maintain patient confidentiality per HIPAA regulations.
• Identify trends in coding errors and recommend improvements.
• Generate reports on billing and coding activities for management.

Skills

Attention to detail

Analytical thinking

Time management

Communication

Education

Associate's or Bachelor's in Health Information Management

Tools

EHR systems

Medical billing software

Job description

Remote Medical Billing and Coding Specialist

Our client, a leading healthcare solutions provider, is seeking a dedicated and detail-oriented Remote Medical Billing and Coding Specialist to join their virtual team. This fully remote position allows you to contribute to efficient healthcare operations from the comfort of your home office. You will play a crucial role in ensuring accurate medical record documentation, optimizing insurance reimbursements, and maintaining compliance with all relevant regulations. The ideal candidate is proficient in translating medical diagnoses and procedures into universally recognized codes. This role requires a high degree of accuracy, strong analytical skills, and the ability to work autonomously. You will be an essential part of a forward-thinking organization that values precision and efficiency in healthcare administration, supporting operations that may span across various provinces, including Eastern Cape, North West, and beyond.

About the Role

Our client, a leading healthcare solutions provider, is seeking a dedicated and detail-oriented Remote Medical Billing and Coding Specialist to join their virtual team. This fully remote position allows you to contribute to efficient healthcare operations from the comfort of your home office. You will play a crucial role in ensuring accurate medical record documentation, optimizing insurance reimbursements, and maintaining compliance with all relevant regulations. The ideal candidate is proficient in translating medical diagnoses and procedures into universally recognized codes. This role requires a high degree of accuracy, strong analytical skills, and the ability to work autonomously. You will be an essential part of a forward-thinking organization that values precision and efficiency in healthcare administration, supporting operations that may span across various provinces, including Eastern Cape, North West, and beyond.

Key Responsibilities

• Accurately assign ICD-10-CM, CPT, and HCPCS codes to diagnoses, procedures, and services based on medical documentation.
• Review patient charts and medical records to ensure completeness and accuracy of coding.
• Submit insurance claims electronically and manually, following up on claim status and resolving rejections or denials.
• Communicate with physicians, other healthcare providers, and insurance companies to clarify information and resolve coding and billing issues.
• Stay up-to-date with changes in coding guidelines, healthcare laws, and insurance regulations.
• Maintain patient confidentiality in accordance with HIPAA regulations.
• Identify trends in coding errors or denials and recommend improvements to documentation or processes.
• Assist in generating reports on billing and coding activities for management review.

Requirements

• High school diploma or equivalent; an Associate's or Bachelor's degree in Health Information Management or a related field is preferred.
• Certification from a recognized coding body (e.g., AAPC or AHIMA) as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).
• Minimum of 3 years of experience in medical billing and coding across various specialties.
• In-depth knowledge of medical terminology, anatomy, physiology, and disease processes.
• Proficiency with electronic health record (EHR) systems and medical billing software.
• Strong understanding of insurance billing and reimbursement procedures.
• Excellent analytical, problem-solving, and critical-thinking skills.
• Ability to work independently with minimal supervision and manage time effectively.
• Reliable internet connection and a dedicated home office space conducive to a remote work environment.

Benefits

• Our client provides comprehensive health insurance benefits, including medical and dental coverage.
• You will have access to ongoing professional development, including continuing education units (CEUs) for maintaining certifications and specialized training in new coding software and regulations.
• Opportunities for career advancement within a growing healthcare administration sector are significant.
• Our client values work-life balance and offers paid time off for holidays and personal leave.
• This fully remote position offers the flexibility to work from anywhere in South Africa, with a competitive annual salary of R.