Healthcare Case Manager, Billing Manager

Summary

Join I STA Personnel Solutions South Africa, a global BPO company, and work remotely as a Healthcare Case Manager | Billing Manager for a USA-based client. This role requires working USA hours (9 am to 6 pm EST) and managing healthcare accounts, ensuring seamless claims processing and authorizations. You will oversee medical billing processes, review clinicals, follow up on claims, and liaise with insurance providers. The position demands strong analytical skills, attention to detail, and excellent communication. This remote role is for South African citizens only and requires a fixed fibre line with a minimum speed of 25 Mbps and a reliable power backup solution.

Requirements

• Minimum of 1 year of experience in leading/managing a team, 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
• A reliable power backup solution

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