Medical Claims AR Specialist
3 weeks ago
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 control numbers (ICN//DCN)
> Research EOBs for payments or adjustments to resolve claim
> Contacts payers via phone or written correspondence to secure payment of claims Access client systems for payment, patient, claim and data info
> Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems
> Secure needed medical documentation required or requested by third party insurance carriers.
> Maintain confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure
> Perform other related duties as required
> Utilize provider billing manuals to obtain billing guidelines and requirements.
> Write appeal letters for technical appeals
> Verifies accuracy of underpayments utilizing contracts and claims data.
> Prepares claims for clinical audit processing in the case of authorization, coding, level of care and/or length of stay denials
> Utilizes reports for analysis and to monitor follow up activities and prioritization
> Assists organization with working through special projects as needed
> SME for colleagues and provide direction for resolution of accounts
> Assists in new hire training
> Assists in content building of training materials
Qualifications & Competencies
> 3+ years of medical collections/billing experience
> Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI
> Expert knowledge of third-party billing guidelines
> Expert knowledge of billing claim forms (UB04/1500)
> Expert knowledge of payor contracts
> Working Knowledge of Microsoft Word and Excel
> Intermediate working knowledge of health information systems (i.e., EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
Preferred Qualifications
> Working knowledge of one or more of the following Patient accounting systems – EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All > > Scripts or Paragon
> Prior team lead experience
> Working knowledge of DDE Medicare claim system
> Knowledge of government rules and regulations
-
Medical Claims AR Specialist
3 weeks ago
Ortigas, Pasig, Philippines Visaya KPO Full timeThe AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...
-
Medical Claims AR Specialist
3 weeks ago
Pasig, Philippines Visaya KPO Full timeThe AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...
-
Medical Claims AR Specialist
3 weeks ago
Pasig, Philippines Visaya KPO Full timeThe AR Specialist III is responsible for post-payment and account follow-up and/or grievance preparation of assigned client accounts receivable. Working at a client site or in a centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and...
-
Accounts Receivable Specialist
3 weeks ago
Ortigas, Pasig, Philippines VISAYA Full timeThe AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...
-
Accounts Receivable Specialist
3 weeks ago
Ortigas, Pasig, Philippines VISAYA Full timeThe AR Specialist II is responsible for billing, re-billing, post-payment/account follow-up, and grievance preparation of assigned. Client Hospital Accounts Receivable. Working at a Client site or in a Centralized location, responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs,...
-
Healthcare RCM hiring
3 weeks ago
Ortigas Center, Pasig City, Philippines BPO Clinicians PH Full timeSalary offer: 30,000 to 35,000 Package Set-up: Work onsite/RTO, Nightshift schedule Location: Ortigas Account: voice *other benefits: - incentive hourly basis - 10% night differential - 13th month pay - HMO plus 1 dependent Qualifications: • At least 1 year experience in inbound healthcare RCM account • Accepting HS graduate old curriculum • Must...
-
Healthcare RCM hiring
3 weeks ago
Ortigas Center, Pasig City, Philippines BPO Clinicians PH Full timeSalary offer: 30,000 to 35,000 Package Set-up: Work onsite/RTO, Nightshift schedule Location: Ortigas Account: voice *other benefits: - incentive hourly basis - 10% night differential - 13th month pay - HMO plus 1 dependent Qualifications: • At least 1 year experience in inbound healthcare RCM account • Accepting HS graduate old curriculum • Must be...
-
Healthcare RCM hiring
3 weeks ago
Pasig, Philippines BPO Clinicians PH Full timeSalary offer: 30,000 to 35,000 PackageSet-up: Work onsite/RTO, Nightshift scheduleLocation: OrtigasAccount: voice*other benefits:- incentive hourly basis- 10% night differential- 13th month pay- HMO plus 1 dependentQualifications: • At least 1 year experience in inbound healthcare RCM account • Accepting HS graduate old curriculum • Must be familiar...
-
IP/OP Medical Coder
3 weeks ago
Ortigas City, Philippines RSD Human Resource Management Consultancy Full timeJob Title: Medical Coder Job Overview: A medical coder plays a critical role in the healthcare industry by translating medical diagnoses, procedures, and services into universal alphanumeric codes. These codes are essential for billing, insurance claims processing, and maintaining accurate patient records. Key Responsibilities: Reviewing Patient Records:...
-
Claims Encoder
2 weeks ago
Ortigas, Pasig, Philippines TOPSERVE SERVICE SOLUTION, INC. Full timeQualifications: Graduate of any four year course. Computer literate Willing to be assigned in MEDASIA With technical knowledge pertaining to medical terminologies, needed for the job is an advantage. With good communication / interpersonal skills Willing to start ASAP
-
IP/OP Medical Coder
3 weeks ago
Ortigas City, Philippines RSD Human Resource Management Consultancy Full timeJob Title: Medical Coder Job Overview: A medical coder plays a critical role in the healthcare industry by translating medical diagnoses, procedures, and services into universal alphanumeric codes. These codes are essential for billing, insurance claims processing, and maintaining accurate patient records. Key Responsibilities: Reviewing Patient Records:...
-
Pasig, Philippines MicroSourcing Full timeWith over 8,000 professionals across 9 delivery centers in the Philippines, MicroSourcing remains the country's largest offshoring solutions provider.Payment Application Associate, be 100% YOU with MicroSourcing!A Payment Application Associate is expected to:Apply remittances consisting of deposits, credit cards, and checks in a timely and efficient...
-
Credit Specialist Representative
3 weeks ago
Ortigas, Pasig, Philippines VISAYA Full timeResponsibilities: · Reviews and resolve credit balances through credit transfers, account corrections and refund request form completion for manual refund check requests. · Posts debits for approved refunds. · Resolves Department credit balance inquiries for transfers and refund check requests. · Understanding of electronic medical record / billing...
-
IP/OP Medical Coder
3 weeks ago
Pasig, Philippines RSD Human Resource Management Consultancy Full timeJob Title: Medical CoderJob Overview:A medical coder plays a critical role in the healthcare industry by translating medical diagnoses, procedures, and services into universal alphanumeric codes. These codes are essential for billing, insurance claims processing, and maintaining accurate patient records.Key Responsibilities:Reviewing Patient Records: Analyze...
-
Credit Specialist Representative
3 weeks ago
Ortigas, Pasig, Philippines VISAYA Full timeResponsibilities: · Reviews and resolve credit balances through credit transfers, account corrections and refund request form completion for manual refund check requests. · Posts debits for approved refunds. · Resolves Department credit balance inquiries for transfers and refund check requests. · Understanding of electronic medical record / billing...
-
Philippines, Pasig City MicroSourcing Full timeWith over 8,000 professionals across 9 delivery centers in the Philippines, MicroSourcing remains the country's largest offshoring solutions provider.Payment Application Associate, be 100% YOU with MicroSourcing!A Payment Application Associate is expected to:Apply remittances consisting of deposits, credit cards, and checks in a timely and efficient...
-
Finance Staff
3 weeks ago
Pasig, Philippines Maximum Solutions Corporation Full timeLocation: Manggahan, Pasig Qualifications: - Graduate of Financial Management/Accountancy or related - With background in accounting—AR or Claims Related - Willing to start immediately
-
Clinical Denials Specialist
3 weeks ago
Pasig, Philippines RSD Human Resource Management Consultancy Full timePerforms advanced level work related to clinical denial management. The individual isresponsible for managing claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, andothers as assigned.
-
Finance Staff
3 weeks ago
Pasig, Philippines Maximum Solutions Corporation Full timeLocation: Manggahan, Pasig Qualifications: - Graduate of Financial Management/Accountancy or related - With background in accounting—AR or Claims Related - Willing to start immediately
-
Finance Staff
3 weeks ago
Pasig City, Philippines Maximum Solutions Corporation Full timeLocation: Manggahan, PasigQualifications:- Graduate of Financial Management/Accountancy or related- With background in accounting—AR or Claims Related- Willing to start immediately