Compliance & Verification Administrator (USA Healthcare) - EST Hours (Remote)

ISTA Personnel Solutions South Africa is a fast-growing global BPO. We are not a recruitment agency — we operate as a dedicated extension of our US-based clients’ teams, providing skilled remote professionals who support daily operations with precision, efficiency, and a personal touch.

We are seeking a Compliance & Verification Administrator (Quality Assurance) to support one of our U.S.-based healthcare clients who provides early intervention services ie. Speech Therapy, Occupational Therapy, Physical Therapy, Special Instruction, Nutrition and Social Work.

This is a highly task-oriented and repetitive role that requires strong attention to detail, consistency, and proactive follow-up.

Role Overview

Each therapist must comply with certain tasks to ensure that services being rendered are documented accurately and billed effectively. The Compliance & Verification Administrator will be responsible for reviewing, verifying, and processing client and provider documentation to ensure compliance with regulatory and internal requirements. This role involves repetitive tasks, so candidates must be comfortable with routine work while maintaining accuracy and focus. The ideal candidate will be proactive, organized, and able to hold providers accountable for compliance requirements.

PLEASE NOTE:

• Working Hours: This role requires you to work EST hours Mon - Fri from 8am to 5pm EST (14h00 to 23h00 South African time - subject to change in accordance with daylight savings in the United States).
• You will be required 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) 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.
• Work Environment: This is a fully remote working role.

Key Responsibilities:

• Verify and review therapists session notes for accuracy and completeness.
• Analyze data to identify anomalies or patterns that may indicate fraudulent activity.
• Coordinate with internal departments to ensure all documentation is complete and accurate.
• Review enrolment requirements and supporting documents to confirm authenticity and validity.
• Communicate with therapists and providers to hold them accountable for compliance.
• Log into the HCSIS system and accept assigned cases promptly.
• Review Individualized Family Service Plans (IFSPs) and Evaluation Reports (ERs) within required timelines.
• Upload verified documents into the provider portal.
• Manage and document PEIDs-related emails.
• Prepare and send welcome letters to clients/families during onboarding.

Requirements

Soft Skills

• Excellent written and verbal English communication skills.
• High attention to detail — accuracy is critical.
• Strong organizational and multitasking abilities.
• Proactive and consistent in follow-up.

Technical Skills

• Basic computer literacy, including MS Office and Outlook.
• Ability to navigate multiple systems and portals.
• Experience with healthcare or early intervention documentation, compliance tracking, or working with therapy providers is a plus
• Previous experience in verification, compliance, or documentation review is a plus.

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