# Insurance Credentialing & Contracting Agent (US Healthcare) | Remote (EST Hrs)

**Company:** [ISTA Personnel Solutions](http://jobs.workable.com/companies/iSt64sfgHWn4ef4KKpqeK9.md)
**Location:** Remote
**Workplace:** remote
**Employment type:** Full-time
**Department:** South Africa

[Apply for this job](http://jobs.workable.com/view/897d7401-5e88-4e6a-96e1-33d034e8feb0)

## 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 U.S.-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.

**Role Summary**

We are seeking a detail-oriented and proactive **Insurance** **Credentialing & Contracting Specialist** for our U.S.-based client, a growing multi-state provider of Applied Behaviour Analysis (ABA) therapy services for children with autism. This role sits at the intersection of compliance and negotiation: you'll manage the credentialing of newly hired clinicians with insurance providers, and drive the research and outreach needed to get the company in-network with new insurers as they expand into new states.

**PLEASE NOTE:**

-   **Working Hours:** Monday to Friday, 15:00 PM – 00:00 AM South African time – subject to changes due to daylight saving.
-   **Public Holidays:** This role requires you to work on both South African and US public holidays (compensation for SA public holidays in accordance with the BCEA).
-   **Internet Requirements:** A fixed fibre line with a minimum speed of 25 Mbps (upload & download), capable of supporting a wired Ethernet connection, is mandatory. LTE, satellite internet (e.g. Starlink), Rain wireless/mobile broadband, and mobile hotspots will **not** be considered.
-   **Power Backup:** A reliable power backup solution - solar, an inverter, or a UPS - capable of sustaining your internet and workstation through load shedding and power outages is required. Applicants without one cannot be considered.
-   **Work Environment:** _This is a fully remote working role._

**Key Responsibilities:**

-   Manage insurance credentialing for newly hired clinicians, updating documentation and portal profiles with individual insurers to ensure compliance and correct billing
-   Research insurance landscapes in new states as the company expands, identifying which insurers to prioritize for network participation
-   Reach out to insurance companies to understand credentialing requirements, application processes, and reimbursement rate structures
-   Negotiate reimbursement rates with insurers where offered rates fall below competitive benchmarks
-   Track credentialing and contracting progress, flagging delays or issues proactively
-   Maintain accurate, audit-ready records across multiple insurer portals and systems
-   Follow established workflows and escalate matters appropriately when required
-   Complete other ad hoc coordination tasks as needed

**Requirements**

-   U.S. health insurance experience, including private insurers and Medicaid
-   Excellent communication skills and strong English fluency (verbal and written)
-   Strong critical thinking and independent problem-solving skills, particularly for the contracting/negotiation side of the role
-   A confident, proactive attitude - comfortable initiating contact with insurers and pushing for better terms
-   Detail-oriented and highly organized, with the discipline to manage multiple portals and deadlines accurately
-   Basic computer literacy, including MS Office and Outlook (no advanced Excel skills required)
-   Experience with ABA-specific insurance processes is a strong plus, but not required
-   Ability to work independently with minimal day-to-day supervision

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