ABA Insurance Verifications & QA Specialist (Remote, USA Hours)

About the role

ISTA Personnel Solutions, a BPO company that partners with international US clients and integrates its staff directly into their operations, is recruiting an ABA Insurance Verifications & QA Specialist for a U.S.-based paediatric therapy centre offering ABA, occupational therapy, speech and language services. The role is fully remote and back-office, supporting a small in-office team by verifying out-of-network insurance benefits, managing authorisations and reviewing session notes. It is not staff-facing at first, though the client wants to grow it into staff-facing work once settled.

Working hours are Monday to Friday, 16:00-01:00 SAST (subject to US daylight saving changes), and applicants must work on both South African and U.S. public holidays. The position is open only to candidates based in South Africa.

Key responsibilities

• Pick up benefit checks from the Monday.com board for new enquiries and existing clients who change insurance
• Call US insurers to verify out-of-network benefits, including coverage or exclusions, visit limits, deductibles, co-insurance and maximum out-of-pocket
• Record benefits accurately on the board and send patient responsibility contracts to parents after payment plans are agreed, following up until signed and returned
• Load real or placeholder authorisations into CentralReach so therapists can bill, and extend or renew them before January, then re-verify benefits in the first two weeks of January
• Review flagged session notes in CentralReach and NoteGuard, check that amendment notes are signed and clear labels so sessions move to payroll
• Resolve rule flags internally where possible and escalate to therapists where needed
• Over time, support authorisation utilisation checks, timesheet authorisation issues and follow-up on unconverted timesheets

Required profile

• Fixed fibre internet (minimum 25 Mbps upload and download) with wired Ethernet capability; applicants without it cannot be considered
• A reliable power backup solution to manage load shedding and outages; applicants without it cannot be considered
• ABA industry experience with terminology such as timesheets, goals, session notes, QA and authorisations; ABA recruiting, onboarding or admin experience is sufficient
• Comfortable speaking with US insurers via telecom
• Excellent written and spoken English, strong attention to detail and accuracy
• Proactive communication, initiative and a friendly, personable manner

Required skills

• Microsoft 365, including Outlook and Excel
• CentralReach and Monday.com experience is beneficial
• US health insurance or benefits verification experience, ideally across ABA, OT and speech, is beneficial