USA Medical Billing Collections - EST hours (Remote)

ISTA Solutions; Johannesburg; Remote; ZAR 50 000 - 200 000; Full time

Job summary

A global BPO company is seeking an experienced Medical Billing Collections specialist in Johannesburg to handle U.S. healthcare insurances. The role demands strong communication skills and an understanding of billing processes. As a remote position, candidates must meet specific internet and power requirements. Responsibilities include collection follow-ups, claims review, and patient data management. Candidates should have a collections background and be proficient in MS Office.

Qualifications

• Understanding of US healthcare billing terms and processes.
• Customer-facing experience requires professionalism and empathy.

Responsibilities

• Follow up with patients to collect payments, establish plans.
• Review exclusion of benefits and resolve claim issues.
• Confirm patient eligibility and coverage details.
• Maintain accurate census data for admissions.
• Handle Medicaid billing and submissions.
• Post and reconcile patient payments and insurance remittances.
• Prepare and submit billing statements ensuring compliance.
• Monitor status of claims and follow up as needed.
• Analyze aging reports and identify overdue accounts.
• Reconcile daily financial transactions.
• Manage documents for proper compliance.
• Update billing systems and document interactions.
• Lower Accounts Receivable by meeting collection targets.
• Ensure compliance with HIPAA regulations.
• Provide updates on collection progress to clients.
• Escalate complex issues and suggest improvements.

Skills

Exceptional English communication skills

Customer Service with a collections background

Skilled in MS Office (Word) and Outlook

Strong work ethic

A fast learner

Excellent problem-solving abilities

Job description

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 fully 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.

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.