USA Medical Billing Collections - EST hours (Remote)

ISTA Solutions; Johannesburg; Remote; ZAR 223,200 - 334,800; Full time

Job summary

ISTA Solutions, a global BPO company, is seeking a Medical Billing Collections specialist to work REMOTELY. This position requires a solid understanding of US healthcare billing processes, professionalism in patient interactions, and adherence to compliance regulations. Candidates must have exceptional communication skills, experience in collections, and a strong work ethic, with roles focused on payment collection, claims management, and problem resolution.

Qualifications

• Experience in medical billing and collections.
• Strong work ethic and fast learner.

Responsibilities

• Patient Payment Collection and Billing processes.
• Claims Review and Billing Compliance.
• Verification of Benefits and Medicaid Processing.

Skills

Exceptional English communication skills

Customer Service

Problem-solving

Tools

MS Office (Word and Outlook)

Job description

USA Medical Billing Collections - EST hours (Remote)

USA Medical Billing Collections - EST hours (Remote)

ISTA Personnel Solutions South Africa is a global BPO company partnering with a U.S.A Medical Billing Company. We are looking for an experienced Medical Billing Collections, specifically handling U.S. healthcare insurances such as Medicare, Medicaid etc.

To excel in this role, a strong understanding of US healthcare, billing terms, and processes is essential. As a customer-facing position, it also demands professionalism and empathy in all patient interactions.

PLEASE NOTE THE FOLLOWING:

• Working Hours: This role requires you to work EST hours, Mon - Fri, from 9am to 6pm EST time (15h00pm to 24h00am South African time - subject to change depending on daylight savings and/or the operational requirements of the Company)
• 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.
  
  

Responsibilities:

• Patient Payment Collection - Follow up with patients to collect payments, establish payment plans, and resolve billing inquiries.
• Claims Review and Billing - Review exclusion of benefits (EOBs), identify errors, and work with insurance providers to resolve claim issues
• Verification of Benefits - Confirm and validate patient eligibility and coverage details with insurance providers
• Census Management - Maintain accurate and up-to-date census data to track patient admissions and discharges
• Medicaid Processing - Handle Medicaid billing, submissions, and follow-ups to ensure compliance and timely reimbursement
• Cash Posting - Accurately post and reconcile patient payments and insurance remittances.
• Billing - Prepare and submit billing statements to insurance providers, ensuring compliance with billing guidelines.
• Claims Tracking - Monitor the status of submitted claims and follow up with insurance providers on denials or discrepancies.
• Aging Analysis - Analyze and manage aging reports to identify overdue accounts and implement follow-up strategies.
• Bank Reconciliation - Reconcile daily financial transactions and resolve discrepancies between payments and records.
• Back Office Support - Save and manage documents received from third parties to ensure proper record-keeping and compliance
• System Management - Use billing systems to update records, track payments, and document interactions.
• AR Reduction - Focus on lowering Accounts Receivable (AR) by meeting collection targets and analyzing aging reports.
• Metrics and Compliance - Meet client-defined benchmarks and ensure compliance with HIPAA regulations.
• Client Communication - Provide regular updates on collection progress and discuss performance metrics with the client.
• Problem Resolution - Escalate complex issues and suggest improvements to enhance collection efficiency
  
  

Requirements

What we are looking for in a candidate:

• Exceptional English communication skills (comprehension, fluency etc.);
• Customer Service with a collections background
• Skilled in MS Office (Word) and Outlook
• Strong work ethic;
• A fast learner;
• Excellent problem-solving abilities
  
  

If you are not contacted within 14 working days, please consider your application unsuccessful.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  IT Services and IT Consulting

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