USA Medical Billing Collections - EST hours (Remote)

Ista Personnel Solutions; Johannesburg; Remote; ZAR 50 000 - 200 000; Full time

Job summary

An established industry player seeks an experienced Medical Billing Collections professional to join their remote team. In this role, you will handle U.S. healthcare insurances, including Medicare and Medicaid, ensuring compliance and timely reimbursement. Your responsibilities will include patient payment collections, claims review, and maintaining accurate census data. This position requires exceptional English communication skills and a strong customer service background. If you thrive in a fast-paced environment and possess a keen attention to detail, this is the perfect opportunity for you to make a significant impact in the healthcare billing sector.

Qualifications

• Exceptional English communication skills are essential.
• Experience in customer service with a focus on collections.

Responsibilities

• Follow up with patients to collect payments and resolve billing inquiries.
• Review claims and work with insurance providers to resolve issues.
• Maintain accurate census data and manage Medicaid billing.

Skills

English communication skills

Customer Service

Problem-solving abilities

Tools

MS Office (Word)

Outlook

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 professional, specifically handling U.S. healthcare insurances such as Medicare and Medicaid. To excel in this role, a strong understanding of U.S. 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:

1. 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).
2. Work Environment: This is a remote role for South African Citizens only.
3. 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.
4. 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:

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

Requirements:

What we are looking for in a candidate:

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

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