πPhilippines
Virtual Healthcare Case Coordinator

ISTA Solutions
πRemote - South Africa
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Summary
Join STA Personnel Solutions South Africa as a Virtual Healthcare Case Coordinator! This remote role, working US hours (9 am to 6 pm EST), involves managing medical billing, authorizations, and case management for Skilled Nursing Facilities (SNFs). You will collaborate with a US-based healthcare client, ensuring timely claim submissions and resolving denials. This position requires strong analytical and communication skills, proficiency in MS Office Suite, and familiarity with medical coding (CPT, ICD-10) and HIPAA compliance. A fixed fibre line internet connection (minimum 25 Mbps) and reliable power backup are mandatory. Only South African citizens will be considered.
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
- 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 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)
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