Case Manager & Billing

Summary

Join STA Personnel Solutions South Africa, a global BPO company, and work remotely as a Healthcare Case Manager & Billing Lead for a USA-based client. This role demands at least one year of US healthcare experience, encompassing medical billing, claims processing, authorization, and case management. You will manage healthcare accounts, oversee billing processes, review clinicals, and liaise with insurance providers. Strong analytical, communication, and organizational skills are essential. The position requires working US hours (9 am to 6 pm EST) and a reliable internet connection with a fixed fibre line and power backup. Only South African citizens are eligible to apply.

Requirements

• Minimum of 1 year of experience in US healthcare settings, with a strong focus on medical billing, coding (CPT, ICD-10), and case management
• Sound knowledge of HIPAA regulations
• Strong analytical skills and good judgment
• Highly detail-oriented and precise
• Efficient in managing and prioritizing emails
• Excellent communication, problem-solving, and organizational abilities
• Follows established processes with accuracy
• Understands processes with the ability to exercise good judgement in taking appropriate next steps
• A fixed fibre line with a minimum speed of 25 Mbps (upload & download) and the ability to support a wired Ethernet connection is mandatory
• A reliable power backup solution is required to manage load shedding and power outages

Responsibilities

• Manage healthcare accounts, ensuring seamless claims processing and authorizations
• Oversee accurate and timely medical billing processes, including coding for services
• Review clinicals for case management and coordinate approvals
• Follow up on claims, resolve denials, and liaise with insurance providers
• Work closely with clinical, administrative, and financial teams to support seamless patient care and billing processes
• Utilize MS Office (Excel, PDF, Outlook) for reporting and documentation
• Ensure compliance with billing policies and healthcare regulations