USA Medical Billing Collections – EST hours (Remote)

ISTA Personnel Solutions South Africa is a global BPO company partnering with a U.S.A Medical Billing Company. We are looking for an experienced Medical Billing Collections, specifically handling U.S. healthcare insurances such as Medicare, Medicaid etc.

To excel in this role, a strong understanding of US healthcare, billing terms, and processes is essential. As a customer-facing position, it also demands professionalism and empathy in all patient interactions.

PLEASE NOTE THE FOLLOWING:

• Working Hours: This role requires you to work EST hours, Mon – Fri, from 9am to 6pm EST time (15h00pm to 24h00am South African time – subject to change depending on daylight savings and/or the operational requirements of the Company)
• 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.

Responsibilities:

• Patient Payment Collection – Follow up with patients to collect payments, establish payment plans, and resolve billing inquiries.
• Claims Review and Billing – Review exclusion of benefits (EOBs), identify errors, and work with insurance providers to resolve claim issues
• Verification of Benefits – Confirm and validate patient eligibility and coverage details with insurance providers.
• Census Management – Maintain accurate and up-to-date census data to track patient admissions and discharges.
• Medicaid Processing – Handle Medicaid billing, submissions, and follow-ups to ensure compliance and timely reimbursement.
• Cash Posting – Accurately post and reconcile patient payments and insurance remittances.
• Billing – Prepare and submit billing statements to insurance providers, ensuring compliance with billing guidelines.
• Claims Tracking – Monitor the status of submitted claims and follow up with insurance providers on denials or discrepancies.
• Aging Analysis – Analyze and manage aging reports to identify overdue accounts and implement follow-up strategies.
• Bank Reconciliation – Reconcile daily financial transactions and resolve discrepancies between payments and records.
• Back Office Support – Save and manage documents received from third parties to ensure proper record-keeping and compliance.
• System Management – Use billing systems to update records, track payments, and document interactions.
• AR Reduction – Focus on lowering Accounts Receivable (AR) by meeting collection targets and analyzing aging reports.
• Metrics and Compliance – Meet client-defined benchmarks and ensure compliance with HIPAA regulations.
• Client Communication – Provide regular updates on collection progress and discuss performance metrics with the client.
• Problem Resolution – Escalate complex issues and suggest improvements to enhance collection efficiency.

Requirements

What we are looking for in a candidate:

• Exceptional English communication skills (comprehension, fluency etc.);
• Customer Service with a collections background
• Skilled in MS Office (Word) and Outlook
• Strong work ethic;
• A fast learner;
• Excellent problem-solving abilities.

If you are not contacted within 14 working days, please consider your application unsuccessful.