Insurance Claims Resolution Specialist

1 day ago


Antipolo City, Calabarzon, Philippines beBeeBilling Full time ₱450,000 - ₱600,000
Medical Biller AR Followup Analyst Role

ClinicMind, a leading provider of Electronic Healthcare Records (EHR) software and Revenue Cycle Management (RCM) services, is seeking a Medical Biller AR Followup Analyst - Work From Home.

This role requires maximizing insurance reimbursement for healthcare practice owners. Key responsibilities include discovering root causes for medical insurance claim denial, underpayment, or delay and proposing resolutions. Additionally, the analyst will interact with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment.

Responsibilities
  • Maximize insurance reimbursement for healthcare practice owners by identifying and resolving payment discrepancies.
  • Discover root causes for medical insurance claim denial, underpayment, or delay and propose effective resolutions.
  • Interact with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment.
  • Plan and execute medical insurance claim denial appeal process to ensure timely resolution.
  • Collaborate with US-based practice owners and clinicians to complete and correct any missing or incorrect data on their insurance claims.
Qualifications
  • Minimum 6 months experience in US-based AR follow-up and charge and payment posting.
  • Familiarity with US medical insurance industry and insurance claims processing cycle.
  • Knowledge of ICD-10, CPT, and HCPC coding systems.
  • Understanding of CMS-1500 and UB-04 claim formats.
  • Experience with Vericle Software is required.
  • Excellent listening, communication, and problem-solving skills.
  • Ability to work autonomously and self-motivated.
Requirements
  • High comfort level working on Eastern Time Zone/US Shift.
  • Good internet access at home.
  • Mobile Hotspot.
  • Laptop/Desktop with at least 8 GB of RAM.


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