A/R follow

1 week ago

Pasig, Philippines Connext Full time

A/R follow - up Specialist with EPIC Healthcare Software | 25% Night Differential | Working Onsite Connext Pasig, National Capital Region, Philippines The A/R Follow-Up Specialist is responsible for billing, re-billing, post-payment, and account follow-up on assigned hospital accounts receivable. The role manages claim status checks, denials, appeals, and payer communication to ensure accurate reimbursement and timely resolution. Responsibilities Access and navigate payer websites and portals to verify eligibility, authorization, and claim status. Update patient demographics and insurance information in appropriate systems. Research and resolve unpaid or denied claims, including missing information, authorization, and control numbers (ICN/DCN). Review EOBs for adjustments and process corrections to resolve claims. Contact insurance payers via phone or written correspondence to secure payment of claims. Research and respond to payer requests for additional documentation. Verify accuracy of underpayments using contracts and claims data. Write appeal letters for technical appeals and denial management. Prepare claims for clinical audit processing (authorization, coding, level of care, length of stay denials). Maintain confidentiality of patient information in accordance with HIPAA regulations and company policy. Collaborate with billing teams, coders, and payment posters to ensure accurate claim processing. Document all claim activity, follow-ups, and resolutions in the billing system. Adhere to payer policies, guidelines, and submission requirements. Perform other related duties as assigned by the AR Manager or Supervisor. Qualifications and Requirements Experience using Microsoft Word and Excel. Familiar with ICD-10, CPT, HCPCS, and NCCI. Familiar with billing claim forms (UB04/1500). Hands-on experience with health information systems (EMR, Claim Scrubbers, Patient Accounting Systems, etc.). Knowledge in third-party billing guidelines and payor contracts. Demonstrates strong organizational and time management skills with the ability to prioritize tasks effectively. Detail-oriented with high accuracy in claim documentation and processing. Clear and coherent both written and verbal communication skills in English. Screening Criteria High school diploma or equivalent required. Minimum of two (2) years of experience in medical collections or billing. Minimum of two (2) years of experience using EPIC healthcare software. Must have a stable employment history. #J-18808-Ljbffr

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