Medical Insurance Verification Agent - U.S. Healthcare | EST Hrs (Remote)

# Medical Insurance Verification Agent - U.S. Healthcare | EST Hrs (Remote)

> ISTA Personnel Solutions · South Africa (Remote) · Full-time · Posted 2026-08-17

**Workplace:** remote

**Department:** SA - Operations

## Description

ISTA Personnel Solutions South Africa is a dynamic and fast-growing BPO company based in South Africa, specializing in providing top-tier operational support to US-based companies. We are not a recruitment agency; we are a dedicated extension of our clients' teams, delivering high-quality service with precision, efficiency, and a personal touch.

We are looking for a **Medical Insurance Verification Agent** to join their team. This role is ideal for someone with previous **U.S. healthcare or medical insurance experience**, particularly experience with **Verification of Benefits (VOB), eligibility verification, pre-authorizations or insurance authorizations**.

The successful candidate will be responsible for verifying patient insurance benefits and, as the role develops, managing utilization review requests and following them through to approval.

**PLEASE NOTE**

• **Working Hours:** Monday to Friday, 8:00 AM – 5:00 PM EST | 2PM to 11PM (SAST), subject to change in accordance with daylight saving time.
• **Internet Requirements:** A dedicated, fixed FIBRE internet connection with a minimum speed of 25 Mbps upload and 25 Mbps download at your remote work location is mandatory. Connections via Rain, LTE, 5G, or similar are not acceptable. Applicants without a fixed fibre line will not be considered.
• **Public Holidays:** Required to work on all South African public holidays and will be compensated in accordance with the provisions of the Basic Conditions of Employment Act (BCEA).
• **Power Backup:** A reliable backup power solution that can support your equipment for the duration of your scheduled working hours during power outages (UPS, inverter, solar, etc.) is mandatory. Applicants without a reliable backup solution will not be considered.
• **Work Environment:** Fully remote within South Africa.

• **Duties & Responsibilities**
• **Verification of Benefits (VOB)**

• Verify patient insurance eligibility and benefits using U.S. insurance portals.
• Confirm that insurance coverage is active and identify relevant benefits and coverage information.
• Accurately capture and document verified insurance information.
• Upload and attach supporting documentation to the relevant patient record.
• Manage approximately **10–15 VOBs per day**, while maintaining a high level of accuracy.
• Identify and communicate any discrepancies or issues with insurance coverage.

**Utilization Review**

• Retrieve and download relevant medical records from the patient management system.
• Prepare complete utilization review packets for submission to insurance providers.
• Submit authorization requests according to each payer's requirements, which may include **email, fax or telephone**.
• Follow up with insurance companies on pending authorization requests.
• Monitor authorization expiry dates and proactively request extensions where required.
• Maintain accurate records of authorization requests, follow-ups and outcomes.
• Take ownership of each request from submission through to obtaining a **response and approval**.
• Ensure that approvals are obtained within the required timeframes to prevent delays in patient care.

**Requirements**

• Previous experience within **U.S. healthcare or U.S. medical insurance** is essential.
• **Excellent English communication skills** — strong conversational fluency, comprehension and professional written communication are essential.
• Previous experience with **insurance verification, eligibility, benefits, authorizations or pre-authorizations**.
• Experience working with U.S. insurance portals and payer processes.
• Experience handling confidential medical and patient information.
• Previous **Verification of Benefits (VOB)** experience.
• Experience with **Utilization Review (UR)**.
• Experience obtaining or following up on insurance authorizations.
• Experience in behavioural health, substance use treatment, ABA or another U.S. healthcare environment.
• Familiarity with U.S. commercial insurance and/or managed care.

_If you are not contacted within 14 working days, please consider your application unsuccessful_.
## Apply
[Apply at ISTA Personnel Solutions](https://apply.workable.com/ista-2/j/BF8CF891E1/apply)
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