Trainer, US Healthcare

6 days ago

Manila, National Capital Region, Philippines MED-METRIX INTERNATIONAL PH-I, INC. Full time $60,000 - $80,000 per year

Experience these Xtraordinary benefits when you join Med-Metrix

  • 8-Hour Shifts, Fixed Weekends Off
  • Day 1 HMO with 2 of your dependents covered for FREE
  • Medical Cash Allowance
  • Rice Allowance
  • Clothing Allowance
  • Free Lunch Daily
  • Paid Time Off
  • Training and Staff Development
  • Employee Engagement Activities
  • Opportunities for Internal Mobility

The Trainer is responsible for conducting medical billing, claim denials & appeals, revenue cycle management training programs for new and existing forensic billers. Performs actual medical billing & claim denials work for existing accounts on a regular basis to keep an up-to-date knowledge of the process. Participates in process implementation during account take offs or go-live.

Duties and Responsibilities

  • Develops curriculum, training syllabus, and course modules related to Medical Billing (US Health Insurance, Claims Process, Denials & Appeals, Revenue Cycle Management)
  • Develop Basic Account Navigation Workflow of Billing System for both HP and PB (Epic, Athena) and other system tools (Encoder Pro, CCI Edit) used by the department.
  • Develops Denials Process workflow for Common Denials (Duplicate, Timely Filing, No Prior-Auth, Medical Necessity, etc.)
  • Develops a guideline for common Payer Policies for the Top US Health Insurance Payers (Aetna, BCBS, Humana, UHC, Cigna, etc.)
  • Update and improve existing training and process modules.
  • Coordinate with forensic quality department to identify areas for process improvement and produce materials for claim edits, denials workflow, systems & process training from client.
  • Develops and produces materials for Medical Billing, Denials, Systems and Process exercises and qualifying examinations.
  • Updates weekly deck (performance and attendance for training meeting).
  • Participates in weekly training meetings with the upper management.
  • Collaborates with billing operations managers, supervisors, and quality to resolve issues that impact internal and external customers.
  • Develops and conducts Call/Phone Handling Training for the new hires and existing forensic billers.

Qualifications

  • Must have completed a Bachelor's Degree.
  • Previous training work experience of at least a year.
  • Minimum of 2 years of medical billing or revenue cycle management experience specific to AR and Denials Management or provider side of the healthcare insurance industry.
  • In-depth understanding of claim denials.
  • CPB and Coding Certification (CPC, CCS, COC) is an advantage.
  • Supervisory experience preferred; demonstrated leadership skills.
  • Willingness and flexibility to work extended hours.
  • Knowledge of general computer applications and ability to multitask on two monitors. Proficient with Microsoft Office products.
  • Must be amenable to work during US hours
  • Must be amenable to work onsite

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