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Billing & Payment Specialist

2 months ago


Manila, National Capital Region, Philippines Alliance Global Solutions Full time
Key Responsibilities:

  • Insurance Claims Processing:
  • Accurately submit insurance claims using diagnostic and procedural codes (ICD10, CPT/HCPCS).
  • Identify and bill secondary and tertiary insurances where applicable.
  • Follow up on rejected or denied claims, ensuring all necessary corrections are made, and resubmitting claims in a timely manner.
  • Payment Posting and Reconciliation:
  • Post payments received from patients, insurance companies, and thirdparty payers (including EFT, check, credit card, and ACH payments).
  • Reconcile posted payments to ensure that actual payments match expected amounts, investigating and resolving discrepancies.
  • Maintain accurate records of all financial transactions and regularly provide reports to management.
  • Patient Communication and Collections:
  • Communicate with patients regarding their financial obligations, explaining billing statements, insurance correspondence, and payment options.
  • Follow up with patients and insurance companies on overdue balances and coordinate payment arrangements as necessary.
  • Manage collections activities by working closely with insurance companies to collect outstanding balances for substance use disorder and other healthcare services.
  • Compliance and Industry Knowledge:
  • Stay updated on changes in healthcare regulations, insurance guidelines (HMO/PPO, Medicare, Medicaid), and billing practices.
  • Ensure adherence to HIPAA and other privacy laws when handling patient financial information.
Skills and Qualifications:

  • Education: High school diploma or equivalent required.
  • Experience: 3+ years of billing, payment posting, and claims collection experience, preferably in the healthcare sector (substance use disorder or mental health services).
  • Technical Skills: Proficiency in healthcare billing systems such as KIPU, CollaborateMD, and familiarity with insurance portals.
  • Organizational Skills: Strong multitasking ability and attention to detail, especially in managing multiple claims, payments, and billing activities simultaneously.
  • Communication Skills: Excellent verbal and written communication skills to interact with patients, insurance companies, and team members.
  • Problem-Solving: Strong analytical skills for resolving discrepancies in claims or payments and addressing denied claims.
Reporting Structure:

Reports directly to the Billing Manager. Collaborates with collections staff, patient finance counselors, and the billing team.

Willing to work onsite and on night shift.