Compliance Officer

15 hours ago

Paranaque City, Calabarzon, Philippines beBeeVerification Full time ₱2,836 - ₱3,758
Appointment Rules Verification Specialist

The role of Appointment Rules Verification Specialist is to ensure the accuracy and compliance of scheduled appointments, preventing billing issues and conflicts.

This position involves meticulous oversight of appointment codes, schedule adjustments, and maintenance of critical scheduling documents.

The specialist will coordinate and verify that appointments do not overlap or conflict with other provider appointments, thereby supporting seamless delivery of services to clients.

  • Review scheduled appointments daily and weekly to ensure there are no conflicts with other providers' appointments
  • Adjust and substitute conflicting appointments with valid alternative codes, ensuring providers can continue delivering services without interruptions
  • Plan and schedule necessary bloodwork and urine screening appointments for clients, ensuring all relevant appointments are accounted for and non-conflicting

To excel in this role, the specialist must have a deep understanding of behavioral health and/or medical appointment requirements, familiarity with Medicaid/Medicare and private insurance scheduling rules, strong attention to detail, time management, and accuracy.

Additionally, the specialist must possess excellent communication and teamwork skills, proficiency with electronic health records (EHRs), scheduling software, and Excel.

Responsibilities: Assist supervisor with work-related tasks, remain informed and compliant with regulations and standards, support safe work environment, maintain confidentiality of all records, participate in external and internal audits/surveys, contribute to quality improvement initiatives, cross-reference scheduled appointments with insurance authorizations, referral requirements, and service limits, flag and resolve scheduling errors, communicate directly with scheduling staff, intake teams, and clinical providers, track trends in scheduling errors, and ensure all services are scheduled in accordance with Medicaid, Medicare, and private insurance policies.

Required Skills:

  • Deep understanding of behavioral health and/or medical appointment requirements
  • Familiarity with Medicaid/Medicare and private insurance scheduling rules
  • Strong attention to detail
  • Time management and accuracy
  • Excellent communication and teamwork skills
  • Proficiency with EHRs, scheduling software, and Excel

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