ISTA Personnel Solutions South Africa - We are a global Business Process Outsourcing (BPO) provider based in South Africa, working with a US-based client in the healthcare revenue cycle management space. We are currently looking for a Virtual Healthcare Case Coordinator with experience in Skilled Nursing Facilities (SNFs) to join our team.
Role Overview:
The successful candidate will be responsible for managing medical billing, initial authorizations, and case management activities related to Skilled Nursing Facilities. You will work remotely and collaborate with our US client during Eastern Standard Time (EST) hours.
PLEASE NOTE:
- Working Hours: This role requires you to work USA hours Mon - Fri from 9am to 6pm EST (15h00pm to midnight South African time, however these hours are subject to change depending on daylight savings).
- 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.
Key Responsibilities:
- Manage patient accounts, including claims processing and authorization tracking.
- Oversee the accurate and timely submission of medical claims, including appropriate coding.
- Review clinical documentation to support authorization and care coordination.
- Investigate and resolve claim denials in collaboration with insurance providers.
- Work alongside clinical, billing, and administrative teams to ensure continuity in patient care and revenue cycle processes.
- Use MS Office (Outlook, Excel, PDF) to manage documentation and communications.
- Ensure compliance with relevant healthcare and data protection regulations (e.g. HIPAA).
Requirements
- Healthcare experience required, preferably with exposure to USA healthcare systems, especially in medical billing, claims, authorizations, and/or case management in SNFs or similar environments.
- Familiarity with medical coding standards (CPT, ICD-10) and HIPAA compliance.
- Strong analytical, problem-solving, and organizational skills.
- High attention to detail and accuracy in documentation and data handling.
- Proficient in MS Office Suite, especially Excel and Outlook.
- Ability to prioritize work, manage high email volumes, and follow established processes.
- Strong written and verbal communication skills.
If you are not contacted within 14 working days, please consider your application unsuccessful.