Billing Specialist

4 months ago


Pasig City, Philippines Visaya KPO Full time

· Utilizes various hospital/physician systems to verify patient, billing and claim information for accuracy.· Performs compliant primary/secondary, tertiary and re-bill billing functions, including electronic, paper and portal submission to government and/or commercial payers.· Edits claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission.· Responds timely to emails and telephone messages, as appropriate.· Communicates issues to management, including payer, system or escalated account issues.· Participates and attends meetings and training seminars, as requested.· Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards.· Enhances billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.· Updates patient demographics/insurance information in appropriate systems.· Monitors claims for missing information, authorization and control numbers (ICN//DCN).· Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems.· Secures needed medical documentation required or requested by third party insurance carriers.· Maintains and respects the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure.In addition:· Utilize provider billing manuals to obtain billing guidelines and requirements· Import verification and escalation of import/export files· Special Handling billing included not limited to interim bills, overlap review, redistribution of money for correct claim creation· Resolve and research billing Rejections



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