Insurance Reimbursement Strategist

1 day ago

Taguig, National Capital Region, Philippines beBeeReimbursement Full time $40,000 - $65,000
Maximize Insurance Reimbursement Specialist

As a specialist in insurance reimbursement, your primary goal will be to maximize insurance reimbursement for healthcare practice owners. This involves identifying root causes for medical insurance claim denial, underpayment, or delay and proposing resolutions.

Responsibilities:
  1. Discover root causes for medical insurance claim denial, underpayment, or delay by analyzing data and communicating with healthcare providers.
  2. Propose effective resolutions for denied or underpaid claims based on research and industry best practices.
  3. Interact with US-based insurance carriers to follow-up on unpaid claims, delayed processing, and underpayment, ensuring timely resolution.
  4. Develop and execute strategies to improve the medical insurance claim denial appeal process, resulting in higher reimbursement rates.
Required Skills and 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 similar field.
  3. Hands-on experience with data analysis and classification, as well as excellent analytical skills.
  4. Familiarity with the US medical insurance industry, including knowledge of ICD-10, CPT, and HCPC codes.
  5. Understand CMS-1500 and UB-04 claim formats.
  6. Experience with Vericle Software is an advantage.
  7. Excellent listening, communication, and problem-solving skills.
  8. Self-motivated and able to work autonomously.
  9. Experience with chiropractic, physical therapy, and mental/behavioral health specialties.
Benefits:
  • High comfort level working on Eastern Time Zone/US Shift.
  • Good internet access at home.
  • Mobile Hotspot.
  • Laptop/Desktop of at least 8 GB.

This role requires a unique blend of technical, analytical, and interpersonal skills. If you're detail-oriented, have excellent communication skills, and are passionate about delivering high-quality results, we want to hear from you

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