Remote Medical Claims Examiner

2 days ago

Ayala Alabang, National Capital Region, Philippines beBeeMedicalBilling Full time $60,000 - $80,000
Job Summary

We are seeking a highly skilled Medical Billing Specialist to join our team. As a Remote Medical Billing Specialist, you will be responsible for managing all third-party billing and collections functions for assigned accounts in the revenue cycle.

Main Responsibilities:
  • Coordinate with various departments to post charges 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 daily to address any denials or requests for additional information (ADRs).
Collections Responsibilities:
  • Follow up on unpaid claims/denials within company standard billing cycle timeframes; determine reasons for denial.
  • Document all communications and collection attempts, taking follow-up action in accordance with established policies and procedures.
  • Provide needed supporting documentation to payer upon request in a timely manner.
  • Maintain A/R Aging levels for assigned accounts within company guidelines.
  • Notify supervisors of difficult/problem accounts; residents unwilling or unable to pay balances.
  • Process claim reclassification to private accounts upon approval from management.
  • Process bad debts in a timely fashion when claims are determined to be uncollectable. Document all reasons for uncollectability and efforts in the process.
Additional Responsibilities:
  • Apply Third Party payments daily including checks, wire transfers, EFT payments, other bank deposits, cash, and credit card payments. Confirm completeness and accuracy of payment information to the residents' accounts.
  • Establish good relationships with all third-party payers with professional communications.
  • Efficiently conduct inquiries and analysis for resolution of discrepancies.
Requirements:
  • 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.
  • One or more years of experience working in a high-volume, short-term rehab environment.
  • Knowledge of billing and related software preferred and/or experience with similar software.
  • Proficiency with Microsoft Office and ability to learn company IT systems.

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