Optimizing Medical Insurance Reimbursement Specialist

22 hours ago

Makati City, National Capital Region, Philippines beBeeAnalytical Full time $55,000 - $65,000
Medical Biller AR Followup Specialist Opportunity

The role involves optimizing insurance reimbursement for healthcare providers by resolving claim denials, underpayments, or delays.

Responsibilities include:

  • Maximizing insurance reimbursement for healthcare practice owners by identifying and addressing claim denial, underpayment, or delay issues.
  • Collaborating with insurance carriers to follow up on unpaid claims, delayed processing, and underpayment.
  • Developing and executing medical insurance claim denial appeal processes.
  • Interacting with healthcare providers to complete and correct missing or incorrect data on their insurance claims.

Required skills and qualifications include:

  • At least 6 months of experience in US-based AR follow-up and charge and payment posting.
  • A degree in a relevant field such as computer engineering, mathematics, or a related discipline.
  • Hands-on experience with data analysis and classification.
  • Excellent analytical and problem-solving skills.
  • Familiarity with the US medical insurance industry and the insurance claims processing cycle.
  • Knowledge of ICD-10, CPT, and HCPC coding systems.
  • Understanding of CMS-1500 and UB-04 claim formats.
  • Experience with data-driven decision making is an advantage.
  • Exceptional listening, communication, and interpersonal skills.
  • Ability to work autonomously and manage multiple priorities.
  • Experience working in chiropractic, physical therapy, and mental/behavioral health specialties is beneficial.

Mandatory requirements include:

  • Comfortable working in Eastern Time Zone/US Shift.
  • Good internet access at home.
  • Mobile hotspot.
  • A laptop/Desktop with at least 8 GB of RAM.

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