AR Complex Clinical Denials Specialist
2 days ago
Job descriptionEssential Duties & ResponsibilitiesVerify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providersUpdate patient demographics/insurance information in appropriate systemsResearch/ Status unpaid or denied claimsMonitor claims for missing information, authorization, and control numbers (ICN//DCN)Research EOBs for payments or adjustments to resolve claimContacts payers via phone or written correspondence to secure payment of claims; reconsideration and appeal submission.Access client systems for payment, patient, claim and data infoFollows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systemsSecure needed medical documentation required or requested by third party insurance carriersMaintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedurePerform other related duties as requiredMinimum Requirements & Competencies:3+ years of medical collections, denials and appeals experienceMust have atleast 6 months of EPIC tool experienceExperience with all but not limited to the following denials- DRG downgrades, level of care, coding, medical necessityIntermediate knowledge of ICD-10, CPT, HCPCS and NCCIIntermediate knowledge of third-party billing guidelinesIntermediate knowledge of billing claim forms (UB04/1500)Intermediate knowledge of payor contracts- commercial and governmentIntermediate Working Knowledge of Microsoft Word and ExcelIntermediate knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)Intermediate of DDE Medicare claim systemIntermediate Knowledge of government rules and regulationsMust be willing to work onsite in Ortigas, Pasig City.Enjoy the ff. Perks and Benefits:15% Night DifferentialHMO Benefits after 30 days + Add Up to 2 DependentsRetirement Benefits24 Leave Credits per year, Convertible to CashWholistic Employee Wellness ProgramJob Type: Full-time
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AR Complex Clinical Denials Specialist
4 months ago
Pasig, Philippines Visaya KPO Full timeJob description Essential Duties & Responsibilities Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers Update patient demographics/insurance information in appropriate systems Research/ Status unpaid or denied claims Monitor claims for missing information,...
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AR Complex Clinical Denials Specialist
4 months ago
Pasig, Philippines Visaya KPO Full timeJob description Essential Duties & Responsibilities Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers Update patient demographics/insurance information in appropriate systems Research/ Status unpaid or denied claims Monitor claims for missing information,...
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Clinical Denials Resolution Expert
1 month ago
Pasig, National Capital Region, Philippines Visaya KPO Full timeVisaya KPO is seeking a highly skilled Clinical Denials Resolution Expert to join our team in Ortigas, Pasig City. This is a full-time position that requires expertise in medical collections, denials, and appeals.About the RoleWe are looking for an experienced professional with a strong background in clinical denials resolution. As a Clinical Denials...
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Financial Services Specialist
1 month ago
Pasig, National Capital Region, Philippines Multistyle Specialist Inc Full timeWe are seeking a skilled professional to join our finance team at Multistyle Specialist Inc. as an Accounts Receivable Specialist with SAP experience.About the RoleThe ideal candidate will be well-versed in construction-related AR functions, including progress billing, lien waivers, and account reconciliation.Key ResponsibilitiesManage project-specific...
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AR Specialist
4 months ago
Pasig City, Philippines Visaya KPO Full timeJob Description The Medical Insurance Accounts Receivable Representative is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables. Responsibilities: Verifies or obtains patient eligibility and/or authorization for healthcare services performed by searching payer web sites or client eligibility...
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AR Specialist
4 months ago
Pasig, Philippines Visaya KPO Full timeJob Description The Medical Insurance Accounts Receivable Representative is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables. Responsibilities: Verifies or obtains patient eligibility and/or authorization for healthcare services performed by searching payer web sites or client...
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AR Specialist
4 months ago
Pasig, Philippines Visaya KPO Full timeJob Description The Medical Insurance Accounts Receivable Representative is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables. Responsibilities: Verifies or obtains patient eligibility and/or authorization for healthcare services performed by searching payer web sites or client...
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Clinical Operations Specialist
4 weeks ago
Pasig, National Capital Region, Philippines Solid Lyndelle Manpower Services Inc. Full time**Job Overview**Solid Lyndelle Manpower Services Inc. is seeking an experienced Clinical Operations Specialist to join our team.About the Role:We are looking for a highly skilled Clinical Operations Specialist to work on-site, Monday to Friday. As a Clinical Operations Specialist, you will be responsible for performing regular audits of clinical practices,...
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AP / AR Specialist
1 month ago
Quezon City, Philippines Nityo Infotech Full timeAP or AR Specialist – Up to 31,000 PHPLocation: Filinvest Alabang (Onsite for the first 3 months, then Hybrid – 2 days RTO)Qualifications:Education: Bachelor’s/College Degree in Finance/Accountancy or equivalentExperience: At least 2 years in AR/AP/general accountingSkills:-- ERP Systems (Oracle/MFG Pro)-- Advanced MS Office & Google applications--...
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AP/AR Finance Specialist
4 weeks ago
Quezon City, National Capital Region, Philippines Nityo Infotech Full timeRole OverviewWe are seeking a highly skilled AP/AR Finance Specialist to join our team at Nityo Infotech. As an AP/AR Finance Specialist, you will be responsible for managing accounts payable and accounts receivable processes, ensuring timely payments and accurate financial reporting.
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Clinical Review Specialist
1 month ago
Cebu and Pasig, Philippines Gratitude Philippines Full timeJob Title: Clinical Review SpecialistWe are seeking a skilled and detail-oriented Clinical Review Specialist to join our team at Gratitude Philippines. Salary: $60,000 - $80,000 per annum, depending on experience.About the Role:This is an exciting opportunity for a Registered Nurse with CIC/CCS certification to work as a Clinical Review Specialist. The...
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AR Specialist healthcare Account
2 days ago
Pasig City, Philippines Visaya Knowledge Process Outsourcing Full timeEssential Duties & ResponsibilitiesVerify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providersUpdate patient demographics/insurance information in appropriate systemsResearch/ Status unpaid or denied claimsMonitor claims for missing information, authorization, and...
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Clinical Support Specialist
3 weeks ago
Pasig, National Capital Region, Philippines Manpower Core Group Inc. Full timeJob Overview">The Manpower Core Group Inc. is seeking a highly skilled Clinical Support Specialist to join their team. This role involves providing exceptional support to the clinical and client teams, ensuring accurate and timely payment of covered claims.">About the Role">">Review contractual language and medical documentation to determine customer...
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Senior Clinical Nurse Auditor Specialist
1 month ago
Pasig, National Capital Region, Philippines Visaya KPO Full timeJob Title: Senior Clinical Nurse Auditor SpecialistWe are seeking a highly skilled Senior Clinical Nurse Auditor Specialist to join our team at Visaya KPO.About the RoleIn this critical role, you will work closely with our Eligibility Enrollment Specialist to obtain referrals from Savista's client. Your expertise in medical records and authorization...
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AR Specialist healthcare Account
4 months ago
Pasig, Philippines Visaya Knowledge Process Outsourcing Full timeEssential Duties & Responsibilities Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers Update patient demographics/insurance information in appropriate systems Research/ Status unpaid or denied claims Monitor claims for missing information, authorization, and...
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AR Specialist healthcare Account
4 months ago
Pasig, Philippines Visaya Knowledge Process Outsourcing Full timeEssential Duties & Responsibilities Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers Update patient demographics/insurance information in appropriate systems Research/ Status unpaid or denied claims Monitor claims for missing information, authorization, and...
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Medical Prior Authorization
5 months ago
Davao City, Philippines Med Supply US Full timePosition Summary:The Prior Authorization Specialist plays a crucial role in the healthcare industry by ensuring that medical services, procedures, and medications are approved by insurance companies or third-party payers before they are rendered or prescribed. They work closely with healthcare providers, insurance companies, and patients to gather and submit...
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Accounts Receivable
2 months ago
Pasig City, Philippines Multistyle Specialist Inc Full timeWe are seeking a skilled Accounts Receivable Specialist with SAP experience to join our finance team in the construction industry. The ideal candidate will be well-versed in construction-related AR functions, including progress billing, lien waivers, and account reconciliation. This role requires a proactive and detail-oriented individual who can manage...
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Accounts Receivable
2 months ago
Pasig City, Philippines Multistyle Specialist Inc Full timeWe are seeking a skilled Accounts Receivable Specialist with SAP experience to join our finance team in the construction industry. The ideal candidate will be well-versed in construction-related AR functions, including progress billing, lien waivers, and account reconciliation. This role requires a proactive and detail-oriented individual who can manage...
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Accounts Receivable
2 months ago
Pasig, Philippines Multistyle Specialist Inc Full timeWe are seeking a skilled Accounts Receivable Specialist with SAP experience to join our finance team in the construction industry. The ideal candidate will be well-versed in construction-related AR functions, including progress billing, lien waivers, and account reconciliation. This role requires a proactive and detail-oriented individual who can manage...