Insurance / Claims Analysts - (Onsite)

3 days ago

Cebu City, Philippines Staff Outsourcing Solutions Full time

REQUIREMENTS:

Experience working as a representative of the providers or members line for queries in eligibility and benefits, claims, and authorizations.
Preferably with experience in inpatient or outpatient services.
Must know the basic insurance terms.
Knowledge in Medical Billing/Claims.
Experience in Revenue Cycle Management (or a part of) required.
The job will be a mix of insurance payment collections, reports generation and phone calls (only 10% calls, or maybe less).
Basic knowledge in Word and Excel is required. Knowledge in Google sheet a plus.

JOB RESPONSIBILITIES:

- Follow-Up with Insurance Carriers via all mediums to determine reason for claims denial and work to resolve medical claims for payment.
- Research problem accounts to ensure accuracy
- Ability to resolve insurance denials and file appeals with government and commercial carriers.
- Analyze the unpaid medical claims and denials and identify/investigate the reasons for nonpayment and which action is needed to resolve timely.
- Adheres to applicable policies, hospital/physician billing/departmental practices and 3rd party requirements.
- Denial Management--analyzing and resolving denied claims. Investigate the reasons for denials, identify errors or discrepancies, and take corrective actions, such as submitting appeals

EXCITING PERKS for successful hires.
Earn 40k up to 65k per month
This is an office-based position located in Cebu Business Park.
Work hours will be US Eastern time. FIXED WEEKENDS OFF.


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