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Verification of Benefits Supervisor

2 weeks ago

Cebu City, Central Visayas, Philippines Emapta Full time $60,000 - $100,000 per year

Championing Fair Pay for Out-of-Network Care

Our client is a leading authority in healthcare revenue cycle management, specializing in Independent Dispute Resolution (IDR) and No Surprises Act compliance. With over 50 years of combined expertise, they empower out-of-network healthcare providers to secure timely and fair reimbursements. Leveraging advanced technology, meticulous documentation, and a deep understanding of regulatory frameworks, they deliver strategic, sustainable solutions that transform financial uncertainty into predictable outcomes-making them a trusted partner in an increasingly complex healthcare landscape.

Job Description

As a Verification of Benefits Supervisor, you will lead daily team operations, mentor staff, and ensure compliance with quality standards. This role focuses on optimizing workflows, supporting performance improvement initiatives, and overseeing case submissions to maintain accuracy, efficiency, and regulatory alignment within the arbitration and dispute resolution process.

Job Overview

Employment Type: Full-Time
Shift: Night Shift
Work Setup: Onsite, Cebu

Exciting Perks Await

  • Day 1 HMO coverage with free dependent
  • Competitive Salary Package
  • Night differential pay to maximize your earnings
  • Prime office location in Cebu (Conveniently accessible by PUVs, with nearby restaurants and banks)
  • Unlimited upskilling through Emapta Academy courses (Want to know more? Visit )
  • Free 24/7 access to our office gyms (Ortigas and Makati) with a free physical fitness trainer
  • Exclusive Emapta Lifestyle perks (hotel and restaurant discounts, and more)
  • Unlimited opportunities for employee referral incentives across the organization
  • Standard government and Emapta benefits
  • Total of 20 annual leaves to be used on your own discretion (including 5 credits convertible to cash)
  • Fun engagement activities for employees
  • Mentorship and exposure to global leaders and teams
  • Career growth opportunities
  • Diverse and supportive work environment

The Qualifications We Seek

Education and/or Experience

  • High school diploma or equivalent required
  • Minimum of 3 years of experience in medical billing and collections
  • Minimum of 1 year of supervisory experience managing a team of more than five people

Skills/Specialized Knowledge

  • Knowledge of CPT and ICD-10 codes
  • Knowledge of legal and regulatory government provisions
  • Understanding of HIPAA and other communications and privacy laws, and their applications
  • Proficiency in Microsoft Office, especially Excel (formulas, pivot tables, filters, etc.)
  • Strong organizational, analytical, and problem-solving skills
  • Knowledge of the insurance industry
  • Familiarity with the independent dispute resolution process
  • Proven ability in negotiation and technical writing
  • Professionalism in handling internal and external communications
  • Excellent verbal and written communication skills
  • Knowledge of medical terminology
  • Experience using MS Office applications including Word, Excel, Access, Outlook, and PowerBI

Other Requirements

  • Must maintain a professional appearance
  • Must be consistently punctual and reliable
  • Must maintain high-speed internet that meets remote work requirements
  • Must be available on weekends to handle urgent action items

Your Daily Tasks

  • Promote department goals by motivating, coaching, and training team members
  • Train new employees on department policies, procedures, processes, and information systems
  • Plan and prioritize schedules, assign tasks, and monitor work to optimize operations
  • Analyze claim reports to identify cases eligible for arbitration
  • Ensure timely submission of all cases
  • Ensure completion of all ineligible disputes
  • Ensure timely submission of informal negotiations and briefs
  • Monitor incoming requests regularly and ensure timely responses
  • Evaluate staff performance and audit work to ensure compliance with expectations and processes
  • Inform staff of changes in policies, procedures, systems, and regulatory requirements
  • Gather and analyze departmental metrics and prepare reports for management review
  • Recommend procedural and system changes to improve processes, operational quality, and efficiency (e.g., job aids, training resources, workflows)
  • Collaborate with upper management to provide updates on findings and outcomes
  • Actively participate in and monitor process improvement initiatives
  • Coordinate with external vendors such as State Department of Insurance (DOI), No Surprises Act (NSA) personnel, and arbitrators/IDRE to resolve issues
  • Maintain attendance and payroll records, and ensure timely processing of employee time-off requests
  • Handle escalated issues and concerns
  • Monitor urgent action items after hours and on weekends as needed
  • Complete and oversee special projects
  • Perform other duties as assigned

Who Are We

Join a team that values camaraderie, excellence, and growth. Recognized as one of the Top 20 Dream Companies of Filipinos in 2024, Emapta stands proudly alongside industry giants, offering stability and exciting career opportunities. Your career flourishes here with competitive compensation, international clients, and a work culture focused on collaboration and innovation. Apply now and be part of the #EmaptaEra