Healthcare Specialist

1 day ago

Pulong Santa Cruz, Calabarzon, Philippines beBeeMedical Full time ₱40,000 - ₱60,000
Job Overview

We are seeking a skilled professional to assist our team in meeting responsibilities in a timely and accurate fashion. This role involves reviewing appeals for medical necessity, faxing appeals to the appropriate party, setting reminders to follow up on appeal status, confirming in-network provider ability to service new members, and attending weekly team meetings, completing assigned tasks.

Key Responsibilities
  • Review appeals for medical necessity and ensure accuracy of information provided.
  • Fax appeals to the designated parties within established timelines.
  • Set reminders to follow up on appeal status and escalate any concerns or issues as necessary.
  • Confirm with in-network providers their ability to service new members and ensure smooth transitions.
  • Attend weekly team meetings, participating actively and contributing to discussions and decision-making processes.
Requirements
  • Candidates must possess at least 2 years of college education and demonstrate strong computer skills, including proficiency in Microsoft programs.
  • Experience in medical billing, preferably in Behavioral Health, is required, along with excellent communication and interpersonal skills.
  • A thorough understanding of internet navigation and ability to work independently with minimal supervision are essential.
Core Values
  • Applicants must be respectful of diverse cultural environments and maintain absolute confidentiality at all times.
  • They should also demonstrate accountability, thoroughness, focus on results, and a constant desire to learn and grow professionally.
Benefits
  • Permanent work-from-home arrangement offers flexibility and convenience.
  • Steady freelance job provides stability and opportunities for growth.
  • Profit-sharing incentive motivates professionals to contribute to the organization's success.
  • Paid time off and holiday pay ensure work-life balance.
  • Annual performance and raise evaluation ensures continuous improvement and recognition of achievements.
  • Quarterly perfect attendance incentive rewards dedication and commitment to the role.

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