Job Description
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.
