Case Manager (Skilled Nursing Facilities) - EST hours (Remote)
- South Africa
- Permanent
- Full-time
- 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 role for South African Citizens only.
- 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.
- 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.
- 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