Healthcare Billing Expert

1 day ago

Davao City, Davao, Philippines beBeeClaim Full time $60,000 - $80,000

Overview

Job Title:

Medical Claims Specialist

Job Description:

This role involves managing medical claims and third-party billing processes to secure payments within defined guidelines. The position entails coordinating with various departments, reviewing charges for accuracy, and preparing timely and accurate billing statements.

Billing Responsibilities:
  • Accumulate information from different departments and post it to resident accounts.
  • Review charges for completeness, consistency, and correctness.
  • Prepare and issue accurate billing statements using electronic systems provided.
  • Monitor submissions daily to address denials or requests for additional information (ADRs).
  • Coordinate ADR submissions within 10 days of receiving the request.
Collections Responsibilities:
  • Follow up on unpaid claims/denials within company-standard timeframes; determine reasons for denial. Correct claims and re-bill when required.
  • Document all communications and collection attempts, taking follow-up action in accordance with established policies and procedures.
  • Provide supporting documentation to payers upon request in a timely manner.
  • Maintain A/R aging levels for assigned accounts within company guidelines.
  • Notify supervisors of difficult/problem accounts; residents unwilling or unable to pay balances.
  • Process claim reclassification to private accounts upon approval from management.
  • Process bad debts in a timely fashion when claims are determined uncollectable. Document all reasons for uncollectability and efforts in the process.
Cash Application:
  • Apply third-party payments daily, including checks, wire transfers, EFT payments, other bank deposits, cash, and credit card payments. Confirm completeness and accuracy of payment information to the residents' accounts.
Customer Service:
  • Establish good relationships with third-party payers through professional communication.
  • Efficiently conduct inquiries and analysis for resolution of discrepancies.
Required Skills and Qualifications:
  • Two to three years of experience processing skilled nursing medical claims with third parties, including Medicare, Managed Care, and Insurance Companies, with a successful track record of collections.
  • One or more years of experience working in a high-volume, short-term rehab environment.
  • Knowledge of billing software preferred and/or experience with similar software.
  • Proficiency with Microsoft Office and ability to learn company IT systems.
Preferred Qualifications:
  • Experience with MatrixCare/Answers on Demand is a plus.
Essential Qualifications:
  • Strong communication, interpersonal, and organizational skills.
  • Detail orientation.
  • Ability to manage multiple priorities.
  • Discretionary judgment.
  • Ability to work independently and as part of a team.
Benefits:

Flexible remote working environment, US Eastern Standard Time (EST), Monday to Friday, 9 am to 6 pm.

Reliable computer, noise-canceling headset, second monitor for enhanced productivity, stable internet connection, and backup internet connection required.

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