Case Manager

3 weeks ago

Angeles, Philippines ISTA Personnel Solutions Full time

Overview 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 Case Manager with Skilled Nursing Facilities 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 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 working role 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. Qualifications 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. #J-18808-Ljbffr

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