A/R follow

4 days ago

Pasig, National Capital Region, Philippines Connext Full time ₱400,000 - ₱600,000 per year

Job Summary

The
A/R Follow-Up Specialist
is responsible for billing, re-billing, post-payment, and account follow-up on assigned hospital accounts receivable. The role manages claim status checks, denials, appeals, and payer communication to ensure accurate reimbursement and timely resolution.

Responsibilities


• Access and navigate payer websites and portals to verify eligibility, authorization, and claim status.


• Update patient demographics and insurance information in appropriate systems.


• Research and resolve unpaid or denied claims, including missing information, authorization, and control numbers (ICN/DCN).


• Review EOBs for adjustments and process corrections to resolve claims.


• Contact insurance payers via phone or written correspondence to secure payment of claims.


• Research and respond to payer requests for additional documentation.


• Verify accuracy of underpayments using contracts and claims data.


• Write appeal letters for technical appeals and denial management.


• Prepare claims for clinical audit processing (authorization, coding, level of care, length of stay denials).


• Maintain confidentiality of patient information in accordance with HIPAA regulations and company policy.


• Collaborate with billing teams, coders, and payment posters to ensure accurate claim processing.


• Document all claim activity, follow-ups, and resolutions in the billing system.


• Adhere to payer policies, guidelines, and submission requirements.


• Perform other related duties as assigned by the AR Manager or Supervisor.

Qualifications and Requirements


• Experience using Microsoft Word and Excel.


• Familiar with ICD-10, CPT, HCPCS, and NCCI.


• Familiar with billing claim forms (UB04/1500).


• Hands-on experience with health information systems (EMR, Claim Scrubbers, Patient Accounting Systems, etc.).


• Knowledge in third-party billing guidelines and payor contracts.


• Demonstrates strong organizational and time management skills with the ability to prioritize tasks effectively.


• Detail-oriented with high accuracy in claim documentation and processing.


• Clear and coherent both written and verbal communication skills in English.

Screening Criteria


• High school diploma or equivalent required.


• Minimum of two (2) years of experience in medical collections or billing.


• Minimum of two (2) years of experience using
EPIC healthcare software.


• Must have a stable employment history.

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