Case Manager

3 days ago

South Africa ISTA Personnel Solutions Full time R1 000 000 - R2 000 000 per year

ISTA 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 Healthcare Case Manager & Billing Lead with USA 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 ****

PLEASE NOTE:

  • 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).
  • 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.
  • Work Environment: This is a fully remote working role.
  • Public Holidays: You will be required to work on all South African public holidays (compensated as per BCEA).

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.
Requirements
  • 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.

  • Field Case Manager, Africa

    7 days ago

    Remote (South Africa) ISI Full time R11 000 - R140 000 per year

    About the role(Only accepting applicants residing in South Africa)The Field Case Manager (FCM) is an essential role within the company, serving as the driving force behind effective claims management. The FCM is responsible for assisting the regional medical case management team with all facets claim management. This role demands a high degree of...

  • Virtual Healthcare Case Coordinator

    3 days ago

    South Africa ISTA Personnel Solutions Full time R250 000 - R500 000 per year

    ISTA Personnel Solutions South Africa - We are a global Business Process Outsourcing (BPO) provider based in South Africa, working with a US-based client in the healthcare revenue cycle management space. We are currently looking for a Virtual Healthcare Case Coordinator with experience in Skilled Nursing Facilities (SNFs) to join our team.Role Overview: The...

  • Manager-Project Management-Overall Project Management

    7 days ago

    South Africa EXL Full time R600 000 - R1 000 000 per year

    DescriptionYou will be working with a range of clients and wider business practices to engineer/re-engineer, design and strategy to help our clients as they embark on the journey to transform their operations. Support the implementation of project management plans. Perform more advanced documentation and reporting tasks. Collaborate with team members to...

  • Paralegal

    3 days ago

    South Africa Pavago Full time R250 000 - R500 000 per year

    Job Title: ParalegalPosition Type: Full-Time, RemoteWorking Hours: U.S. client business hours (with flexibility for filings, hearings, and discovery deadlines)About the Role:Our client is seeking a Paralegal to provide substantive legal support to attorneys in litigation, corporate, and compliance matters. This role requires advanced legal research, drafting...

  • Clinical Manager

    2 weeks ago

    South Africa LumiraDx UK Ltd Full time

    **_Please note this is a remote-based role, however ideally, you will be based in either _**_Johannesburg, Cape Town or Durban - or within commuting distance from either of these cities. - ** LumiraDx is a global company with headquarters in the US and UK. We are a dynamic diagnostics company with over 1,000 employees developing breakthrough medical devices...

  • Employee Relations Manager

    1 week ago

    South Africa Office Shoes Full time R600 000 - R1 200 000 per year

    Job DescriptionThe Employee Relations Manager will be a key member of the HR Management team, responsible for developing, implementing, and managing strategies and programs that foster a positive, fair, and productive work environment. This role is a critical partner to business leaders and employees, providing expert guidance on a wide range of employee...

  • Financial Manager

    1 week ago

    South Africa Nedbank Private Wealth Full time R500 000 - R1 000 000 per year

    Requisition Details & Talent Acquisition Specialist REQ Keabetswe ModiseClosing Date: 28 November 2025LocationNedbank 135 Rivonia Campus – Sandton - Hybrid Job Family Finance Career Stream Accounting Leadership Pipeline Manage Others Job Purpose To analyse; interpret; collate and present financial and non financial information in order...

  • Billing Operations Cluster BOC Case Manager

    2 weeks ago

    Billings Operation Centre JHB South, South Africa Netcare Full time R250 000 - R500 000 per year

    We provide meaningful careers that connect people with purpose.We are united by a common purpose of providing the best and safest care; and by our shared values of Care, Truth, Participation, Compassion and Dignity. Netcare invites you to be part of our journey.KEY WORK OUTPUT AND ACCOUNTABILITIESDISRUPTIVE INNOVATIONClinical Risk Management• Apply...

  • Project Manager

    1 week ago

    Johannesburg, South Africa iOCO Pty Ltd Full time

    We’re looking for a Project Manager within the Telecoms space to join our team. This will be for an initial 6-month contract based in Johannesburg. What you'll do: The project manager will be supporting the consumer prepaid channels business Your Expertise: Understanding of core telecoms systems such as prepaid billing systems, formal and informal prepaid...

  • Responsible Gaming Manager

    3 days ago

    Sandton, South Africa Initiate International Full time R500 000 - R750 000 per year

    Our client, a fast-growing company in the online gaming industry is seeking a Responsible Gaming Manager to join its team in Johannesburg. This role focuses on customer protection and ensuring compliance with regulatory standards. The ideal candidate will monitor systems and processes to safeguard vulnerable customers, analyze risks, and collaborate with...