Team Lead for US Healthcare Billing BAU

6 days ago


Mandaluyong City, National Capital Region, Philippines ISTA Solutions Full time

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you

Account Specific Roles And ResponsibilitiesTeam Lead:
  • Lead and mentor a team of billing specialists focused on authorizations and credentialing.
  • Provide training, coaching, and support to ensure team members are up to date on best practices, policies, and procedures.
  • Monitor team performance and provide feedback, ensuring high standards of accuracy and productivity.
  • Schedule and delegate daily tasks to ensure the timely processing of authorizations, credentialing, and claims.
  • Conduct regular team meetings to discuss challenges, workflow improvements, and best practices.
Authorization Management:
  • Obtain necessary pre-authorization approvals for medical services as required by insurance companies.
  • Verify eligibility and benefits through insurance portals or direct contact with insurance carriers.
  • Ensure timely submission of authorization requests and follow up on pending approvals.
  • Maintain accurate records of all authorization communications, approvals, and denials.
Credentialing:
  • Ensure that healthcare providers are properly credentialed with insurance companies and other third-party payers.
  • Prepare and submit credentialing applications, including supporting documentation.
  • Follow up with insurance companies to ensure timely processing and approval of credentialing applications.
  • Monitor and maintain up-to-date provider credentialing files, ensuring compliance with payer requirements.
Billing & Claims Processing:
  • Prepare and submit clean and accurate claims to insurance carriers in a timely manner.
  • Follow up on unpaid or denied claims, resolving issues as necessary.
  • Reconcile patient accounts and handle inquiries related to billing discrepancies.
  • Ensure compliance with billing regulations and payer guidelines.
Compliance and Documentation:
  • Maintain up-to-date knowledge of insurance requirements, authorization processes, and credentialing guidelines.
  • Stay informed about changes in insurance policies, regulations, and industry standards.
  • Ensure that all documentation related to authorizations, credentialing, and billing is accurate, complete, and compliant.
Requirements
  • 1 year BPO experience handling US Healthcare Insurance
  • At least 6 months Team Lead experience
  • Good working knowledge in checking and processing Authorization
  • Knowledge with Healthcare Claims and Billing
  • Good verbal and written English skills
  • Must be willing to work on-site in Shaw, Mandaluyong or Buendia, Makati
  • Amenable working night shifts
Benefits

What can we offer you?

  • Competitive salary and benefits
  • Health Insurance with free dependents*
  • 10%-night differential
  • Attendance Bonus
  • Paid time off
  • Convertible to cash leave credits
  • Performance Appraisal
  • Work-life balance
  • A focus on growing your career path with us
  • We encourage you to follow your passions and learn new skills
Our commitment to you
  • Strong culture and values-driven leadership
  • We create opportunities for you to learn and grow at any stage of your career
  • Continuous learning and innovation
  • We foster an all inclusive environment where everyone thrives
Seniority level
  • Mid-Senior level
Employment type
  • Full-time
Job function
  • Business Development and Sales
Industries
  • IT Services and IT Consulting
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