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Healthcare AR Specialist

4 weeks ago

Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time
Job Title: Healthcare AR Specialist

We are seeking a highly skilled and experienced Healthcare AR Specialist to join our team at Visaya Knowledge Process Outsourcing. As a key member of our team, you will be responsible for resolving medical claims and ensuring timely payment from insurance carriers.

Key Responsibilities:
  • Verify and obtain eligibility and authorization for patients using payer websites, client eligibility systems, or phone calls with insurance carriers.
  • Update patient demographics and insurance information in relevant systems.
  • Research and resolve unpaid or denied claims by identifying missing information, authorization, and control numbers.
  • Monitor claims for missing information and follow up with payers to secure payment.
  • Access client systems for payment, patient, claim, and data information.
  • Follow guidelines for prioritization, timely filing deadlines, and notation protocols within systems.
  • Secure medical documentation required by third-party insurance carriers.
  • Maintain patient confidentiality in accordance with insurance collection guidelines and corporate policy.
Requirements:
  • 2-3 years of experience in medical collections, denials, and appeals.
  • At least 6 months of experience with the EPIC tool.
  • Intermediate knowledge of ICD-10, CPT, HCPCS, and NCCI.
  • Intermediate knowledge of third-party billing guidelines and payor contracts.
  • Intermediate working knowledge of Microsoft Word and Excel.
  • Intermediate knowledge of health information systems, including EMR, claim scrubbers, and patient accounting systems.
Preferred Requirements:
  • Intermediate knowledge of patient accounting systems, including EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon.
  • Intermediate knowledge of the DDE Medicare claim system.
  • Intermediate knowledge of government rules and regulations.