ISTA Personnel Solutions is hiring a Medical Billing & Claims Specialist to take full ownership of the medical claims lifecycle for a US healthcare client. You will manage the entire revenue cycle, from submission through denial resolution and payment follow-ups, ensuring accurate and efficient processing.
What You'll Do
- 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.
What We're Looking For
- Minimum 2+ years of Medical Billing & Coding experience.
- 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.
Nice to Have
- Strong understanding of US healthcare systems and insurance processes.
Technical Stack
- Proprietary EMR
- Monday.com
- MS Office
- Outlook
Work Mode
This is a fully remote position open to candidates based in South Africa. The role requires working EST hours to align with US-based clients and insurance providers.
ISTA Personnel Solutions is an equal opportunity employer.
