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Medical Billing & Claims Specialist (US Healthcare) - Remote | EST Hours at ISTA Personnel Solutions. ISTA Personnel Solutions South Africa is a fast-growing global BPO, partnering with a US-based healthcare client that provides medical and therapy services to nursing homes through Nurse Practitioners (NPs) and Physician Assistants (PAs).. We are seeking an experienced and detail-oriented . Medical Billing & Claims Specialist. to take full ownership of the medical claims lifecycle — from submission to denial resolution and payment follow-ups.. This is a revenue-cycle-focused role ideal for someone who understands US healthcare billing processes and can independently manage rejected or denied claims with confidence.. PLEASE NOTE:. Working Hours: . Monday – Friday | 9:00 AM – 6:00 PM EST (4:00 PM – 1:00 AM South African time – subject to daylight savings).. Public Holidays: . This role requires working on both South African and US public holidays (SA public holidays compensated in accordance with the BCEA).. Internet Requirements:. A fixed fibre line with a minimum speed of 25 Mbps (upload & download) and wired Ethernet capability is mandatory. Applicants without a fixed fibre line cannot be considered.. Power Backup:. Reliable backup required to manage load shedding or outages. Applicants without a power backup cannot be considered.. Work Environment:. Fully remote (SA WFH).. Key Responsibilities:. Own the full lifecycle of medical claims from submission through to payment posting and resolution . Investigate, correct, and resubmit denied or rejected claims . Follow up with US insurance providers regarding unpaid or outstanding claims . Ensure accurate billing aligned with CPT, ICD-10, and payer guidelines . Work within the client’s proprietary EMR and Monday.com to track workflows . Maintain detailed and compliant documentation . Identify recurring billing issues and recommend process improvements. Minimum . 2+ years of Medical Billing & Coding experience. . Strong understanding of . US healthcare systems and insurance processes. (advantageous). Proven experience handling . rejected claims and denial management. . Solid knowledge of . CPT, ICD-10, and revenue cycle workflows. . Ability to independently clean up and follow up on claims . Highly organized, detail-oriented, and proactive . Strong critical thinking and problem-solving skills . Comfortable using MS Office and Outlook . Excellent written and verbal English communication skills. If you are not contacted within 14 working days, please consider your application unsuccessful.. Company Location: South Africa.