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Case Manager & Billing (USA Healthcare) - EST hours (Remote) at ISTA Personnel Solutions. I. STA Personnel Solutions. . South Africa - . we are a global BPO company, partnering with a USA-based client offering Billing and Accounts Receivable Management Services in the Healthcare Sector, and are seeking a. Healthcare Case Manager & Billing Lead . with . USA experience.. This role requires a . minimum of 1-year experience . in the USA Healthcare Industry, with strong knowledge of medical billing (claims), initial authorization processing (In-patient) and case management (reviewing clinicals) and MS Office.. **** PLEASE DO NOT APPLY IF YOU DO NOT HAVE HEALTHCARE EXPERIENCE - YOU WILL NOT BE CONSIDERED!! ****. 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 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.. . . 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. . If you are not contacted within 14 working days, please consider your application unsuccessful. . Company Location: South Africa.