19 Medical Billing jobs in South Africa

ISTA Personnel Solutions South Africa is a global BPO company partnering with a U.S.A Medical Billing Company. We are looking for an experienced Medical Billing Collections, specifically handling U.S. healthcare insurances such as Medicare, Medicaid etc.

To excel in this role, a strong understanding of US healthcare, billing terms, and processes is essential. As a customer-facing position, it also demands professionalism and empathy in all patient interactions.

PLEASE NOTE THE FOLLOWING:

• Working Hours: This role requires you to work EST hours, Mon - Fri, from 9am to 6pm EST time (15h00pm to 24h00am South African time - subject to change depending on daylight savings and/or the operational requirements of the Company)
• Work Environment: This is a fully remote working role.
• 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.

Responsibilities:

• Patient Payment Collection – Follow up with patients to collect payments, establish payment plans, and resolve billing inquiries.
• Claims Review and Billing – Review exclusion of benefits (EOBs), identify errors, and work with insurance providers to resolve claim issues
• Verification of Benefits – Confirm and validate patient eligibility and coverage details with insurance providers.
• Census Management – Maintain accurate and up-to-date census data to track patient admissions and discharges.
• Medicaid Processing – Handle Medicaid billing, submissions, and follow-ups to ensure compliance and timely reimbursement.
• Cash Posting – Accurately post and reconcile patient payments and insurance remittances.
• Billing – Prepare and submit billing statements to insurance providers, ensuring compliance with billing guidelines.
• Claims Tracking – Monitor the status of submitted claims and follow up with insurance providers on denials or discrepancies.
• Aging Analysis – Analyze and manage aging reports to identify overdue accounts and implement follow-up strategies.
• Bank Reconciliation – Reconcile daily financial transactions and resolve discrepancies between payments and records.
• Back Office Support – Save and manage documents received from third parties to ensure proper record-keeping and compliance.
• System Management – Use billing systems to update records, track payments, and document interactions.
• AR Reduction – Focus on lowering Accounts Receivable (AR) by meeting collection targets and analyzing aging reports.
• Metrics and Compliance – Meet client-defined benchmarks and ensure compliance with HIPAA regulations.
• Client Communication – Provide regular updates on collection progress and discuss performance metrics with the client.
• Problem Resolution – Escalate complex issues and suggest improvements to enhance collection efficiency.

What we are looking for in a candidate:

• Exceptional English communication skills (comprehension, fluency etc.);
• Customer Service with a collections background
• Skilled in MS Office (Word) and Outlook
• Strong work ethic;
• A fast learner;
• Excellent problem-solving abilities.

If you are not contacted within 14 working days, please consider your application unsuccessful.

Rockstar is recruiting for a mission-driven mental health practice focused on delivering exceptional care to older adults, particularly those covered by Medicare. This client connects clients with experienced, compassionate therapists through secure virtual and in-person sessions. They are growing quickly and looking for passionate team members who want to shape the future of geriatric mental health.

About the Client

Sailor Health is a mission-driven mental health practice focused on delivering exceptional care to older adults, particularly those covered by Medicare. They connect clients with experienced, compassionate therapists through secure virtual and in-person sessions. They are growing quickly and looking for passionate team members who want to shape the future of geriatric mental health.

Role Overview

The client is seeking a detail-oriented RCM Analyst to manage and optimize their revenue cycle processes. This role is central to ensuring accurate and timely claim submissions, resolving denials, and maintaining a smooth flow of billing data between their EHR (Healthie) and clearinghouse (Office Ally). The ideal candidate is self-driven, highly analytical, and thrives in a fast-paced environment with lots of moving pieces.

Key Responsibilities

• Prepare, submit, and track insurance claims via Office Ally for services documented in Healthie

• Monitor claim status, correct errors, and follow up proactively to ensure prompt payment

• Analyze and resolve claim denials and rejections, coordinating with clinicians when needed

• Manage payer enrollments and credentialing data accuracy in EHR and clearinghouse systems

• Maintain clean and up-to-date patient insurance and billing records

• Prepare regular reports on claim status, aging, denial trends, and reimbursement performance

• Create and maintain spreadsheets and pivot tables in Excel to support revenue analysis and workflow tracking

• Collaborate closely with clinical operations to ensure documentation and coding compliance

• Continuously identify and recommend improvements to billing workflows and documentation processes

Qualifications

• 2+ years of experience in medical billing, revenue cycle management, or healthcare finance

• Experience working with behavioral health or telehealth organizations strongly preferred

• Familiarity with Medicare billing requirements is a significant plus

• Proficient in Office Ally and/or similar clearinghouses, and EHR platforms (Healthie preferred)

• Advanced Excel skills, including pivot tables and advanced formulas

• Exceptionally detail-oriented, organized, and thorough

• Strong communication skills and ability to collaborate across clinical and operational teams

• Comfortable working in a fully remote, fast-growing startup environment

Why Join Them?

• Help build the operational backbone of a mission-driven healthcare startup

• Work alongside a dedicated team of professionals improving access to geriatric mental health care

• Competitive compensation and benefits

• Opportunity for growth and expanded responsibility as the company scales

Job Title:
Billing & Medical Claims Processor

Schedule:
Monday – Friday | 8:00 a.m. – 5:00 p.m. PST

(5:00 p.m. – 2:00 a.m. South Africa Standard Time)

Location:
Remote – Based in South Africa

Reports To:
Director of Accounting & Finance

About the Opportunity

Total Care Connections—one of the largest home care providers in Arizona and Colorado—is seeking a detail-oriented and experienced
Billing & Medical Claims Processor
to join our growing team.

This full-time remote role is based in South Africa but aligned with U.S. Pacific Standard Time hours. The ideal candidate has strong English communication skills, experience in U.S. medical billing and claims management, and a proven ability to work in a fast-paced healthcare environment.

About the Role

As a Billing & Medical Claims Processor, you will be responsible for the
end-to-end revenue cycle process
, including billing, claims submission, adjudication, payment posting, collections, and accounts receivable management. You will ensure accuracy, compliance, and timeliness in all financial transactions, while serving as a key support to the Director of Accounting & Finance.

This role is critical to ensuring that Total Care Connections maintains healthy cash flow and compliance across all payer types.

Key Responsibilities
Billing & Claims Management

• Prepare, review, and submit accurate claims through
  Office Ally
  and
  Waystar
  for private insurance, Medicaid, Medicare, VA, long-term care insurance, and private pay clients.
• Verify insurance eligibility and benefits prior to billing.
• Ensure all claims meet payer-specific requirements, HIPAA regulations, and industry coding standards.
• Track, manage, and resolve claim rejections and denials; submit corrections and appeals as needed.
• Maintain claim status logs and follow up with payers to ensure timely adjudication.

Accounts Receivable & Collections

• Post payments (EFT, ACH, credit card, checks) accurately and reconcile against remittance advice (ERA/EOB).
• Manage client invoicing, account statements, and collections activities, including outbound calls for past-due accounts.
• Monitor aging reports and escalate overdue balances.
• Process refunds, adjustments, and write-offs in accordance with company policy.
• Maintain accurate A/R records for monthly reporting.

Revenue Cycle Operations

• Perform daily reconciliation of deposits and payment postings.
• Conduct audits of claims and payments to identify errors, trends, or compliance risks.
• Support prior authorization requests and documentation when required.
• Collaborate with schedulers, nurses, and caregivers to resolve billing discrepancies tied to services rendered.
• Assist with monthly close by preparing A/R and collections reports.

Compliance & Process Improvement

• Stay current with Medicare, Medicaid, and private payer billing regulations.
• Ensure strict adherence to HIPAA and internal confidentiality requirements.
• Identify opportunities to improve billing efficiency and accuracy.
• Support internal and external audits related to billing and claims.

Qualifications

• Bachelor's degree preferred (Accounting, Finance, Healthcare Administration, or related field).
• Minimum 2–3 years of experience in U.S. medical billing and claims processing, preferably in home health or healthcare.
• Proficiency with
  Office Ally, Waystar, ERA/EOB posting, and payment systems (ACH, credit card processing).
• Strong knowledge of medical claims adjudication, payer rules, and denial management.
• Excellent English communication skills (written and spoken).
• Highly detail-oriented, organized, and able to manage multiple tasks in a fast-paced environment.
• Comfortable making professional collections calls to clients and payers.
• Ability to work 8:00 a.m. – 5:00 p.m. PST (night shift in South Africa).

• Application Deadline: 5 November 2025
• Job Location: Johannesburg, Gauteng
• Job Title: Insurance Claims Manager
• Education Level: Certificate
• Job Level: Management
• Minimum Experience: Years

We are looking for a dynamic, hands-on Head of Claims with 6–10 years' experience in the short-term insurance industry, the majority of which should be within the claims environment.

You'll bring both leadership and operational depth — someone who can drive strategy and lead teams, but who also understands the nuances of claims workflows, client service, and insurer engagement.

This is a role for someone who thrives in a fast-paced, empowered environment — someone who can make decisions, solve problems, and constantly challenge the status quo to make our claims experience best-in-class.

Salary on offer: Negotiable based on experience.

Duties and Responsibilities:

• Leadership & Strategy
• Lead and manage the entire Claims Department across all lines of business.
• Develop and execute claims strategies aligned with company growth and service goals.
• Empower, mentor, and hold your team accountable for performance and client outcomes.
• Drive innovation and continuous improvement in claims processes and customer experience.
• Operational Excellence
• Oversee front-end claims management and ensure efficient turnaround times.
• Identify process gaps and implement practical, measurable solutions.
• Maintain strong relationships with insurer partners, assessors, and service providers.
• Ensure claims compliance with all binder and regulatory obligations.
• Culture & Collaboration
• Actively contribute to the leadership team — challenging and supporting where needed.
• Foster a positive, high-performance culture that reflects Bsure's values of empowerment, integrity, and accountability.
• Be proactive in suggesting restructuring, process improvements, or new initiatives that drive better outcomes for clients and teams.
• Performance & Reporting
• Monitor and manage claims ratios, turnaround times, and customer satisfaction metrics.
• Provide data-driven insight and recommendations to the executive team.
• Ensure operational reporting and performance tracking is accurate, clear, and actionable.

Requirements:

• 6–10 Years' experience in short-term insurance, with a significant portion in claims.
• Proven leadership or management experience within a claims environment.
• Strong understanding of insurer relationships, binder structures, and compliance requirements.
• Excellent communication, problem-solving, and decision-making skills.
• Able to operate autonomously while collaborating across multiple departments.
• Driven, accountable, and motivated by results and continuous improvement.

Bsure Insurance Advisors is one of South Africa's most progressive and people-centric brokerages. We partner with a multitude of insurers and handle key binder functions across underwriting, claims management, and renewals — all while maintaining an obsessive focus on service, empowerment, and culture.

We don't micromanage. We believe in accountability, execution, and ownership. Our leaders operate with autonomy and integrity, constantly looking for better ways to structure, improve, and evolve the business.

We are looking for a dynamic, hands-on Head of Claims with 6–10 years' experience in the short-term insurance industry, the majority of which should be within the claims environment. You'll bring both leadership and operational depth — someone who can drive strategy and lead teams, but who also understands the nuances of claims workflows, client service, and insurer engagement.

This is a role for someone who thrives in a fast-paced, empowered environment — someone who can make decisions, solve problems, and constantly challenge the status quo to make our claims experience best-in-class.

Key Responsibilities

Leadership & Strategy

• Lead and manage the entire Claims Department across all lines of business.

• Develop and execute claims strategies aligned with company growth and service goals.

• Empower, mentor, and hold your team accountable for performance and client outcomes.

• Drive innovation and continuous improvement in claims processes and customer experience.

Operational Excellence

• Oversee front-end claims management and ensure efficient turnaround times.

• Identify process gaps and implement practical, measurable solutions.

• Maintain strong relationships with insurer partners, assessors, and service providers.

• Ensure claims compliance with all binder and regulatory obligations.

Culture & Collaboration

• Actively contribute to the leadership team — challenging and supporting where needed.

• Foster a positive, high-performance culture that reflects Bsure's values of empowerment, integrity, and accountability.

• Be proactive in suggesting restructuring, process improvements, or new initiatives that drive better outcomes for clients and teams.

Performance & Reporting

• Monitor and manage claims ratios, turnaround times, and customer satisfaction metrics.

• Provide data-driven insight and recommendations to the executive team.

• Ensure operational reporting and performance tracking is accurate, clear, and actionable.

⸻

Requirements

• 6–10 years' experience in short-term insurance, with a significant portion in claims.

• Proven leadership or management experience within a claims environment.

• Strong understanding of insurer relationships, binder structures, and compliance requirements.

• Excellent communication, problem-solving, and decision-making skills.

• Able to operate autonomously while collaborating across multiple departments.

• Driven, accountable, and motivated by results and continuous improvement.

⸻

Who You Are

• Dynamic, decisive, and take ownership of outcomes.

• You don't need to be micromanaged — you manage your space, your people, and your results.

• Thrive in a culture that values empowerment, execution, and personal accountability.

• Love working with people, solving problems, and finding better ways to do things.

• Understand that leadership means both guarding and growing your team.

⸻

Why Bsure

At Bsure, our people are the priority.

We work hard, grow fast, and build together. You'll be joining a culture that believes in genuine empowerment, high accountability, and mutual respect — all in a team that's constantly expanding its footprint in the short-term insurance space.

Build Your Career with ICS in our Short-Term Insurance Claims Talent Pipeline (AUS Operations)

Are you a seasoned Short-Term Insurance professional ready for your next international opportunity?

At Insure-Connect Services (ICS), we're growing our talent pipeline for upcoming remote opportunities supporting Australian insurance brokers and firms.

While this isn't an immediate vacancy, we're proactively connecting with experienced candidates who want to be first in line when exciting roles open up - typically within
4 to 8 weeks
.

About ICS

ICS partners with international brokers and insurance firms to deliver top-tier claims and underwriting talent. As our global client base expands, we're building a strong, pre-qualified network of professionals ready to step into dynamic roles as soon as demand arises.

Role Snapshot

You'll handle
end-to-end claims administration
across
Commercial, Personal, and Motor Lines
, supporting brokers and clients to ensure seamless, compliant, and efficient claims resolution - all while maintaining world-class service standards.

What You'll Do

• Manage claims from first notification to final settlement.
• Validate coverage, assess claims, appoint assessors, and drive resolution.
• Maintain detailed records and ensure compliance with insurer and regulatory standards.
• Liaise professionally between clients, brokers, and insurers to ensure clarity and timeliness.
• Support cost control and process efficiency through accurate documentation and follow-ups.

You'll thrive if you enjoy:

Problem-solving and keeping things running smoothly, clear communication, client satisfaction and working independently in your own structured and remote setup.

What We're Looking For

• Matric (Grade 12)
  or equivalent NQF4 qualification.
• 3+ years' experience
  in Short-Term Insurance Claims (Commercial, Personal, and Motor).
• Strong communication skills and professional English.
• Confident using claims management systems and MS Office.
• Reliable remote setup with stable power and internet (loadshedding-ready).

Why Join Our Talent Network?

• Be first in line for international remote roles as soon as they become available.
• Work with well-established AUS brokers and insurance partners.
• Gain international exposure while working from South Africa.
• Enjoy structured onboarding, growth opportunities, and continuous learning.

If you're ready to grow your career and connect with leading global insurers - join the ICS Talent Network today

? Motor Claims Consultant – George, South Africa

Join Pacific International Insurance – Where Compassion Meets Excellence

Pacific International Insurance is an Australian-based company, proudly serving customers in Australia and New Zealand through our flagship brand, PD Insurance. We specialise in pet and motor insurance, and we're excited to be expanding our South African branch

We're on the lookout for a service-driven, empathetic, and proactive Motor Claims Consultant to join our growing team in George. If you're passionate about helping people and thrive in a fast-paced, customer-focused environment, we'd love to hear from you

Why This Role Matters

As a Motor Claims Consultant, you'll play a key role in ensuring claims are processed accurately, efficiently, and compassionately. You'll help manage claims costs in line with policy guidelines, industry regulations, and delegated authorities. Most importantly, you'll be the voice of our Soft Landings philosophy, delivering exceptional customer service from claim lodgement to closure.

Working Hours

• Monday to Friday: 00h00 – 08h00 AM (these hours are subject to change and rotational shifts may be applied to support the requirements of the business).

These hours align with our Australian clients, giving you more flexibility during your day.

Location: George, South Africa (on-site)

Be part of a global team with a local heartbeat.

Ready to make a difference in people's lives while growing your career?

Apply now and become part of a company that values compassion, collaboration, and continuous improvement.

What We're Looking For

If you tick these boxes, we'd love to receive your application:

• Grade 12 / National Senior Certificate.
• Excellent written and verbal communication in English.
• Excellent computer skills.
• Previous experience in a customer service role.
• Strong attention to detail, organisational and admin skills.
• Willingness to work nightshift hours.

Bonus skills that'll set you apart

• Experience in insurance claims or financial services.
• Strong negotiation, persuasion, and investigative abilities.
• Excellent interpersonal skills and ability to build rapport.
• Skilled in asking probing questions to gather detailed information.

Requirements:

• Grade 12
• Clear criminal and credit record.
• Advantageous:
• Knowledge of microinsurance claims and complaints regulations,
• Knowledge of Treating Customers Fairly principles,
• Additional South African Languages,
• Knowledge of Lewis Stores processes and procedures.

Ideal Experience:

• 3 years + experience in a managerial position (incl assistant management position)
• Claims and Complaints handling.

Competencies:

• Proficient in English
• Computer literate in MS Office (Word, Outlook and Excel)
• Proficient communication skills verbally and written
• Able to manage a team effectively
• Attention to detail
• Self-motivated, committed and a driver of performance
• Disciplined in meeting deadlines and agreed targets

Responsibilities:

Insurance claims – MANAGE CLAIMS ASSESSMENT team, REVIEW ASSESSMENT, assist & REPORT:

• Reporting into the Insurance Claims Manager.
• A team of Customer Protection Insurance claims clerks will report into you.
• Review and approve the assessment of authorised, declined or queried Customer Protection Insurance claims.
• Monitor daily claims reports and assist claims clerks to resolve difficult claims that are not being finalised.
• Ensure that the 48-hour SLA report and Pending Preview report is cleared daily by the claims team.
• Ensure that the Pending Complete report is followed-up and cleared daily and where required follow-up with Lewis Stores Branch Accounts regarding outstanding journals.
• Ensure that the Stock Replacement report is followed-up daily and escalate goods replacements with Lewis Stores senior management where required.
• Monitor the Claims Indexing clerk's workload through the incoming claims mailbox and Papertrail indexing queue and ensure that emails and incoming documents are cleared daily.
• Manage and guide the claims clerks daily to finalise claim assessments efficiently when dealing with queries, follow-up, goods replacements etc. as the claims team works with customers lodging a claim, branch operational staff, and/or head office branch accounts.
• Monitor claims follow-up processing ensuring approved processes and procedures are followed.
• Ensure that claim escalations or disputes are referred to Monarch senior management in a timely manner.
• Prepare and attend daily/weekly claims meetings with your claims team and management.
• Monitor claims team in line with the criteria documented in the monthly / quarterly staff incentive letters.
• Assist senior management with queries and / or follow-up requests from the insurance regulator (PA / FSCA), the National Finance Ombuds Scheme, South African Insurance Association (SAIA), South African Special Risks Insurance Association (SASRIA) etc.
• Assist with providing information on claims queries received from e.g.: the Lewis Stores finance department, Lewis Stores Internal Audit department or management.

STAFF MANAGEMENT – CLAIMS

• Monitor daily attendance and report to Insurance Claims Manager incorrect clock-ins where required.
• Monitor and request overtime and leave requests with the Insurance Claims Manager.
• Assist the Insurance Claims Manager to conduct interviews for claim clerk vacancies when necessary.
• Attend to daily staffing needs and queries.
• Assist with further developments/improvements where necessary.
• Identify areas of training needs.

Job Type: Full-time

Work Location: In person

Pet Insurance Claims Consultant |  Qualified Vet Nurse Required

Are you a qualified veterinary nurse with a passion for pets and people? Join us as we launch an exciting new pet insurance brand in Australia! We're on the lookout for compassionate, detail-oriented Pet Claims Consultants to help us deliver exceptional service to pet parents across Australia.

About the Role

As a Claims Consultant, you’ll be at the heart of our customer experience—supporting pet owners during some of their most vulnerable moments. You’ll assess claims with empathy and accuracy, ensuring a smooth and transparent process from start to finish. This is more than just a job—it’s a chance to be part of something meaningful, helping pets live healthier, happier lives.

Key Responsibilities

Claims Management

• Review and process pet insurance claims with precision and care.


• Assess veterinary documentation to determine eligibility under policy guidelines.


• Make informed decisions on approvals, partial payments, or rejections.


• Identify and escalate potential fraud.


• Negotiate claim costs where appropriate.

Customer & Stakeholder Support

• Communicate empathetically with policyholders via phone and email.


• Provide clear updates and guidance throughout the claims process.


• Liaise with veterinarians and clinics to gather necessary documentation.

Documentation & Compliance

• Maintain accurate records in our claims system.


• Ensure compliance with internal policies, industry regulations, and legal standards.


• Contribute to continuous improvement initiatives in claims handling.

Working Hours

This role supports the Australian market and requires flexibility to work semi-aligned with Australian business hours.

Monday to Friday: 06:00 – 15:00

These hours are subject to change based on business needs and daylight savings.

Why Join Us?

You’ll be part of a purpose-driven team committed to protecting the health and wellbeing of pets across Australia. We offer a supportive, collaborative environment where empathy, integrity, and service excellence are at the core of everything we do.

Ready to Apply?

If you're a qualified vet nurse ready to make a difference in the lives of pets and their people, we’d love to hear from you!

What You’ll Need to Succeed

Essential:

• Veterinary nursing qualification  (required)


• Strong understanding of veterinary terminology and procedures


• Excellent communication and customer service skills


• High attention to detail and analytical thinking


• Ability to manage multiple priorities


• Proficiency in office and data entry software

Desirable:

• Experience in insurance claims or financial services


• Previous work in pet insurance or veterinary practice


• Strong negotiation and investigative skills


• Ability to build rapport with customers and service providers