Senior AR Caller

4 days ago

Manila, National Capital Region, Philippines Optum Full time ₱1,200,000 - ₱2,400,000 per year

Job Qualifications:

  • SHS Graduate
    or
    Completed at least 2 years of college
    .
  • Minimum of
    3 years
    of experience as an
    AR Caller or Senior AR Caller
    in
    Revenue Cycle Management (RCM)
    , with a focus on
    Denial Management
    .
  • Hands-on experience in
    Physician Billing
    ,
    Hospital Billing
    , or
    both
    , using forms such as
    UB-04
    and/or
    CMS-1500
    .
  • Willing to work
    on-site in Taguig, Alabang or in Quezon City
    .
  • Experience in a BPO Healthcare Account is required.

Skills:

  • Strong
    problem-solving abilities
    , including
    root cause analysis
    for claim denials.
  • Familiarity with
    Capitation Agreements
    and their impact on billing and reimbursement.
  • Excellent communication and analytical skills to interact with insurance companies and resolve issues efficiently.

Key Responsibilities:

  • Review and analyze denied claims to determine root causes and take corrective actions.
  • Contact insurance companies to resolve outstanding claims and ensure timely reimbursement.
  • Interpret and apply payer-specific guidelines, including capitation agreements.
  • Document all actions taken on claims in the billing system accurately and promptly.
  • Collaborate with internal teams to escalate and resolve complex denial issues.
  • Maintain up-to-date knowledge of billing regulations, payer policies, and industry best practices.
  • Meet productivity and quality targets as defined by the operations team.

Your role is critical in providing confidence in the exceptional care we offer to our members, families, facilities, and health professionals. This is an everyday opportunity to do your life's best work.

WHAT WE OFFER

  • Market Competitive Pay Levels
  • Retirement Plan
  • Medical Plan (HMO) from Day 1 of employment
  • Dental, Medical, and Optical Reimbursements
  • Life and Disability Insurance
  • Paid Time-Off Benefits
  • Sick Leave Conversion
  • Tuition Fee Reimbursement
  • Employee Assistance Program (EAP)
  • Annual Performance Based Merit Increases
  • Employee Recognition
  • Training and Staff Development
  • Employee Referral Program
  • Employee Volunteerism Opportunity
  • All Mandatory Statutory Benefits

WHO WE ARE

  • Optum
    is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.
  • UnitedHealth Group
    is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.
  • We're a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.
  • As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.
  • We're a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines.
  • Elevate your career with a leading health care company while improving lives.

Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that's dedicated to
Caring. Connecting. Growing together

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