Healthcare Revenue Operations Expert

4 days ago


Mandaluyong City, National Capital Region, Philippines Penbrothers Full time

About Penbrothers

We are a fast-growing HR & remote talent management partner, committed to providing talented Filipinos with global opportunities in high-growth startups and dynamic companies from the comfort of their own homes.

About the Mission

Our client's mission is to revolutionize the healthcare industry by establishing a new standard of affordable, preventative care beyond traditional hospital settings. They aim to empower independently-owned practices to accept and work with insurance profitably, eliminating the risk and administrative hurdles associated with insurance. This enables entrepreneurial providers to launch and expand successful in-network practices, ultimately increasing access to affordable healthcare across the US.

About the Opportunity

We are seeking a detail-oriented Medical Billing and Claims Specialist to play a crucial role in our revenue operations team. In this position, you will oversee the entire claims management process, including daily claim submissions, posting payments, denials management, and client billing support. You will collaborate closely with providers, patients, and insurance companies to resolve billing issues, process claims, and ensure compliance with healthcare regulations.

Key Responsibilities:

  • Overseeing the quality and execution of daily claim submissions and payment transactions.
  • Managing the daily reconciliation of charges, adjustments, and payments.
  • Following up on claims and submitting reconsiderations and appeals as needed.
  • Interacting with providers and clients in a positive, professional manner, with sensitivity to financial discussions.
  • Maintaining and enhancing knowledge on revenue cycle operations.
  • Notifying the team of changes in insurance company policies and guidelines.
  • Providing support with other functions as needed.

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