US Healthcare Billing Specialist BAU
6 days ago
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 ResponsibilitiesAuthorization 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.
- 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.
- 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.
- 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.
- 6 months - 1 year BPO experience handling US Healthcare Insurance
- 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
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
- 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
- Entry level
- Full-time
- Health Care Provider
- IT Services and IT Consulting
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