Clinical Case Manager (US Healthcare) - Remote

Overview

ISTA Personnel Solutions South Africa is a global BPO partnering with a USA-based healthcare client providing services within Skilled Nursing Facilities (SNFs), post-acute care, and revenue cycle management.

In Short

• Remote role requiring healthcare experience in SNFs and medical billing.
• Manage complex healthcare cases and coordinate with US insurance providers.
• Work USA hours from Monday to Friday, 9 am to 6 pm EST.
• Must have a fixed fibre internet line with a minimum speed of 25 Mbps.
• Requires a reliable power backup solution for outages.
• End-to-end case management for US healthcare clients.
• Review clinical documentation and process authorizations.
• Ensure HIPAA compliance and accurate medical billing.
• Collaborate with various teams for case management.
• Manage high volumes of emails professionally.

Requirements

• Knowledge of ICD-10 and CPT coding.
• 1–3 years of healthcare experience.
• Experience in case or account management.
• Familiarity with SNFs or post-acute care.
• Experience in inpatient authorization processing and clinical review.
• Strong background in medical billing.

Benefits

• Compensation for work on South African public holidays.
• Opportunity to work with a USA-based healthcare client.
• Fully remote work environment.