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Healthcare Appeals & Case Coordinator - EST Hours (Remote)

4 weeks, 2 days ago
South Africa
Full-time
Mid Level
Operations Specialist
Customer and Technical Support
Apply Now
ISTA Solutions

ISTA Solutions

ISTA Solutions is a one-stop outsourcing company that provides quality and cost-efficient services and solutions. They offer tailor-made workflow solutions, skilled agents dedicated to clients, global resources for comprehensive support, and a focus on...

Professional Services
251-1K
Founded 2015
View All Jobs 25

Description

  • Manage approximately 15+ active patient cases per day with speed, urgency, and accuracy.
  • Coordinate patient case documentation, status updates, and follow-up actions.
  • Draft, submit, and monitor medical appeals and insurance-related supporting documentation.
  • Process NOMNCs and similar patient insurance notices.
  • Conduct regular inbound and outbound communication with insurance providers.
  • Perform provider follow-ups regarding authorizations, documentation, and care updates.
  • Maintain a high-volume inbox of approximately 100–150 emails daily.
  • Keep patient notes, file updates, and case progression records accurate and current in real time.
  • Escalate urgent denials, delays, and unresolved payer issues appropriately.
  • Ensure strict turnaround times are met in a deadline-sensitive environment.

Requirements

  • Minimum 3 years of experience in healthcare case coordination, medical insurance communication, managed care, appeals, authorizations, or similar healthcare support roles.
  • Proven experience handling high patient or case volumes in a fast-paced environment.
  • Strong multitasking ability across calls, emails, systems, and documentation simultaneously.
  • Excellent written and verbal English communication skills.
  • Highly computer literate with the ability to quickly learn client systems and processes.
  • Strong attention to detail and urgency in follow-up.
  • Ability to work independently and remain calm under pressure.
  • Availability to work USA hours Monday to Friday from 9:00 am to 6:00 pm EST (3:00 pm to 00:00 am South African time), subject to daylight savings changes.
  • Fixed fibre internet with a minimum speed of 25 Mbps upload and download and support for a wired Ethernet connection.
  • Reliable power backup solution to manage load shedding and power outages.
  • Prior clinical or patient-care exposure (advantageous).
  • Previous experience supporting U.S. or international healthcare teams (advantageous).

Benefits

  • Fully remote working role.
  • Compensation for working on South African public holidays as per BCEA.
  • Opportunity to support an established U.S.-based healthcare client.
  • Stable long-term operations role within a growing BPO company.

Interested in this position?

Apply directly on the company website

Apply Now

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