# 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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