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 fully 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.
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.
