
Customer Service Representative
4 days ago
Job Purpose:
- The Medical Claims Analyst is responsible for collections, account follow up, billing and allowance posting for the accounts assigned to them.
Duties and Responsibilities:
- Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
- Meets and maintains daily productivity/quality standards established in departmental policies
- Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
- Adheres to the policies and procedures established for the client/team
- Knowledge of timely filing deadlines for each designated payer
- Performs research regarding payer specific billing guidelines as needed
- Ability to analyze, identify and resolve issues causing payer payment delays
- Ability to analyze, identify and trend claims issues to proactively reduce denials
- Communicates to management any issues and/or trends identified
- Initiate appeals when necessary
- Ability to identify and correct medical billing errors
- Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
- Understanding of under or over payments and credit balance processes
- Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required
- Act cooperatively and courteously with patients, visitors, co-workers, management and clients
- Work independently from assigned work queues
- Maintain confidentiality at all times
- Maintain a professional attitude
- Other duties as assigned by the management team
- Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Understand and comply with Information Security and HIPAA policies and procedures at all times
- Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Qualifications:
- Completed at least High School education
- Minimum 1 year of Healthcare Account Receivable/Collections in a BPO setting or environment (claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers)
- Experienced on medical billing/ AR Collections
- Background in calling insurance (Payer) to verify claim status and payment dispute
- Strong interpersonal skills, ability to communicate well at all levels of the organization
- Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
- Gracious and welcoming personality for customer service interaction
Benefits:
- 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
Job Types: Full-time, Permanent
Pay: Php33,000.00 per month
Benefits:
- Health insurance
- Life insurance
Work Location: In person
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