Medical Bill Processor | BPO Healthcare | Muntinlupa City
3 weeks ago
JOB SUMMARY The Medical Bill Processor is responsible for ensuring accurate and timely processing and payment of bills, including pre-coding, data entry, and adjudication of non-medical claims. This role also involves conducting provider outreach and obtaining necessary documentation and data to support claim processing. JOB RESPONSIBILITIES Examines, enters, and adjudicates Network Manager (NWM) bills to include case coding, vendor look-up, data entry, calculating benefits based on provider contract discounts, plans, exclusions Examines, enters, and adjudicates patient reimbursement bills, PCA invoices, prescription bills, and medical bills/claims to include case coding, vendor look-up, data entry, calculating benefits based on provider contract discounts, rates, plans, exclusions Enters and adjudicates injured worker reimbursement forms including reviewing form for proper documentation, calculating benefits, and ensuring timeliness of payment Reviews keying exception queue to bill image to accurately key the bill into the bill review system Enters other non-medical bills into bill review system for processing Conduct proactive outreach to healthcare providers via phone and/or email to obtain necessary documentation and data, ensuring accurate and timely payments. Maintain accurate and detailed records of all outreach activities and communications within the company’s CRM system. JOB REQUIREMENTS Graduate of any four-year college course With 2 years customer service experience with a minimum of 2 years claims or bill review experience and provider/carrier outreach with intermediate computer experience using Microsoft Word, Excel & Outlook required Typing speed of 60 WPM and 10‑key experience. Excellent organizational skills. Knowledge of ICD‑9, CPT, RVS, U&C, Fee Schedule, HCPCS & other coding schemes preferred. Language Skills – Excellent oral communication skills and phone presence. Ability to effectively present information to providers as well as to employees of the organization Reasoning Ability – Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret a variety of instructions and deal with abstract and concrete variables. PERKS OF JOINING ADEC HEALTHCARE Competitive Salary Work Onsite (Alabang Corporate Center) HMO DAY1 with FREE one dependent*** FREE Shuttle 15% night differential Rice Allowance Clothing Allowance Laundry Allowance Healthy working environment Free webinars and internal trainings/events and more Office Location Alabang Corporate Center #J-18808-Ljbffr
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