Medical Reimbursement Specialist

6 days ago


Rizal, Philippines beBeeReimbursement Full time ₱250,000 - ₱400,000
About the Role

We are seeking a detail-oriented Medical Biller AR Follow-up Specialist to maximize insurance reimbursement for healthcare practice owners. This individual will work from home, utilizing expertise to resolve medical insurance claim denials and delays.

Key Responsibilities:
  • Discover root causes of medical insurance claim denial, underpayment, or delay and propose resolutions to optimize payment processing.
  • Interact with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment, ensuring timely resolution.
  • Plan and execute medical insurance claim denial appeal process, leveraging industry knowledge to achieve favorable outcomes.
  • Collaborate with practice owners and clinicians to correct data on their insurance claims, enhancing accuracy and compliance.
Required Skills and Qualifications:
  • 6 months experience in US-based AR follow-up and charge payment posting, with a strong understanding of the insurance claims processing cycle.
  • Familiarity with US medical insurance industry, including ICD-10, CPT, HCPC, CMS-1500, and UB-04 claim formats.
  • Experience with Vericle Software, with ability to navigate complex systems and troubleshoot issues.
  • Excellent communication, problem-solving, and listening skills, with a customer-centric approach.
Benefits:
  • High comfort level working on Eastern Time Zone/US Shift, with flexibility to adapt to changing deadlines.
  • Good internet access at home, with reliable connectivity for seamless workflow.
  • Mobile Hotspot, Laptop/Desktop of at least 8 GB, ensuring optimal performance and productivity.


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