Medical Claim Specialist

2 days ago

San Juan, National Capital Region, Philippines beBeeCollections Full time ₱48,000 - ₱68,000
Job Description:

The Billing and Collections Specialist will be responsible for managing billing processes to secure payments within defined company guidelines for Medicare, Medicaid, Managed Care, Co-insurance companies, and Long Term Care Insurance Companies. This position involves coordinating with various departments to post charges to resident accounts, reviewing charges for accuracy, completeness, consistency and payers charged, and preparing and timely issuing accurate billing statements to the correct payer using electronic systems provided.

The Billing and Collections Specialist will also be responsible for monitoring all submissions on a daily basis to address any denials or requests for additional information (ADRs). Additionally, they will coordinate with all departments and submit ADR information within 10 days of receipt of request.

Responsibilities:

  • Coordinate accumulation of information with various departments; post to resident accounts.
  • Review charges for accuracy, completeness, consistency and payers charged.
  • Prepare and timely issue accurate billing statements to the correct payer using electronic systems provided.
  • Monitor all submissions on a daily basis to address any denials or requests for additional information (ADRs).
  • Coordinate with all departments and submit ADR information within 10 days of receipt of request.

Required Skills and Qualifications:

The ideal candidate will have two to three years of experience processing skilled nursing medical claims with third parties including Medicare, Managed Care and Insurance Companies with a track record of successful collections. They will also have one or more years of experience working in a high-volume, short-term rehab environment. Knowledge of billing and related software is preferred and/or experience with similar software.

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:

This is a remote position that offers flexibility and convenience. The ideal candidate will have strong communication skills and be able to work effectively in a remote environment.

Requirements:

  • A reliable computer and noise-canceling headset
  • A second monitor for enhanced productivity
  • A stable internet connection
  • A backup internet connection

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