Healthcare Claims Specialist

3 hours ago

Pasay, National Capital Region, Philippines beBeeMedical Full time $70,000 - $90,000

ClinicMind is seeking a Medical Biller AR Followup Analyst. We are a leading provider of Electronic Healthcare Records (EHR) software and Revenue Cycle Management (RCM) services.

Responsibilities
  1. Maximize insurance reimbursement for healthcare practice owners by identifying and resolving payment delays, underpayments, or denials.
  2. Analyze medical insurance claims and develop effective resolutions to root causes of denial, underpayment, or delay.
  3. Interact with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment.
  4. Develop and implement a plan to execute medical insurance claim denial appeal process.
  5. Collaborate with US-based practice owners and clinicians to complete and correct any missing or incorrect data on their insurance claims.
Qualifications
  1. Minimum of 6 months experience in US-based AR follow-up and charge and payment posting.
  2. College degree in Computer Engineering, Mathematics, or related field.
  3. Hands-on experience with data analysis and data classification.
  4. Good analytical skills and ability to work independently.
  5. Familiarity with the US medical insurance industry and insurance claims processing cycle.
  6. Knowledge of ICD-10, CPT, and HCPC coding systems.
  7. Understanding of CMS-1500 and UB-04 claim formats.
  8. Experience in Vericle Software is an advantage.
  9. Excellent communication and problem-solving skills.
  10. Self-motivated and able to work autonomously.
  11. Experience with chiropractic, physical therapy, and mental/behavioral health specialties.
Must-Haves
  1. High comfort level working on Eastern Time Zone/US Shift.
  2. Good internet access at home.
  3. Mobile Hotspot.
  4. Laptop/Desktop of at least 8 GB RAM.

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