ar follow up specialist

1 week ago

Ayala Alabang, National Capital Region, Philippines ADEC INNOVATIONS HEALTHCARE, INC Full time ₱900,000 - ₱1,200,000 per year

JOB SUMMARY

We are seeking a detail-oriented and results-driven professional to support the financial integrity of our organization through the accurate and timely recovery of outstanding medical claims. The ideal candidate will bring strong analytical capabilities, exceptional communication skills, and in-depth knowledge of insurance claims processes. This role is instrumental in optimizing revenue cycle performance and ensuring compliance with payer requirements.

JOB RESPONSIBILITIES

1.     Review and resolve outstanding claim accounts from worklists or management direction, focusing on denied claims across various payers and regions.

2.     Analyze account history and conduct in-depth research, including review of patient charts and encounter documentation, to support resolution.

3.     Investigate and follow up on denied claims, identifying causes related to coding discrepancies or contract issues. Prepare and attach appropriate documentation, gather additional information, and submit corrected claims to facilitate accurate and timely adjudication.

4.     Initiate and manage appeals for denied claims by researching root causes, collecting necessary documentation, making necessary account adjustments, and resubmitting claims. Maintain follow-up activities to ensure final resolution.

5.     Communicate claim issues and denial trends to leadership and contribute to continuous process improvement.

6.     Identifies, researches, and ensures timely processing of payments and error corrections, ensuring appropriate documentation of payments, allowances, denial, rejections, are recorded on individual accounts

7.     Review remittance advice and investigate underpayments or overpayments.

8.     Perform additional A/R tasks and support other departmental responsibilities as assigned.

9.  Reports security incidents and/or any identified security weaknesses.

10.  Performs other tasks that may be assigned from time to time.

JOB REQUIREMENTS

  • Graduate of any 4year college degree
  • Must have 2+ years in a Healthcare BPO setting
  • Knowledge of commercial, HMO, Medicare/Medicaid, and other payer requirements.
  • Working knowledge on the use of insurance payer websites ie: Availity, Optum, Medicare, Evicore portals.
  • Working knowledge with Practice Management systems, preferably KAREO a plus.
  • Effective communication abilities with and not limited to team members outside clients and patients.
  • Proven problem-solving skills. The ability to research and resolve complex insurance denials while obtaining a clear understanding to present actionable solutions.
  • Proficient knowledge of medical terminology is likely to be encountered in medical claims denials.
  • Denial management experience is a plus

PERKS OF JOINING US

  • Competitive Salary
  • Hybrid arrangement (Training and nesting period is ONSITE-Alabang)
  • HMO on Day1 with FREE ONE DEPENDENT***
  • 15% Night Differential
  • US Shifts
  • Free Shuttle
  • Employee referral bonus
  • Employee engagements
  • Healthy working environment
  • Free webinars and internal trainings/events and more

Office Location: Alabang Corporate Center

  • AR Follow-up Specialist

    4 days ago

    Ayala Alabang, National Capital Region, Philippines ManpowerGroup Full time ₱450,000 - ₱600,000 per year

    Job Requirements:Graduate of any college degree.Must have 2+ years in a Healthcare BPO settingKnowledge of commercial, HMO, Medicare/Medicaid, and other payer requirements.Working knowledge on the use of insurance payer websites ie: Availity, Optum, Medicare, Evicore portals.Working knowledge with Practice Management systems, preferably KAREO a...

  • Junior Medical AR

    2 days ago

    Ayala Alabang, National Capital Region, Philippines Gear Inc Full time ₱900,000 - ₱1,200,000 per year

    Job Location: Muntinlupa, Metro Manila, PhilippinesJob Name: Junior Medical AR & Denial Management Specialist Job Description:  Sign-On Bonus Offered Join us and receive a competitive sign-on bonus as a welcome to our growing team Our leading AI platform specializing in medical billing operations, is seeking dedicated and detail-oriented Medical AR and...

  • AR Specialist

    2 days ago

    Ayala Alabang, National Capital Region, Philippines Rentokil Initial Full time ₱900,000 - ₱1,200,000 per year

    Rentokil InitialRentokil Initial is an international business services company employing 46,031 colleagues across 88 countries.We strive to protect people and enhance lives, for example by controlling pests, and improving hygiene. We are experts in the fields we operate in, investing in training, science, innovation and technology. Listening and acting on...

  • Principal AR Specialist, Human Resources

    7 days ago

    Ayala Alabang, National Capital Region, Philippines Capital One Full time ₱900,000 - ₱1,200,000 per year

    Alabang , Philippines, Muntinlupa City, National Capital Region (Manila)Principal AR Specialist, Human ResourcesSummary:To assist the Principal HR Specialist, supervise HR coordinators, and manage and ensure day-to-day operations meet standards and achieve goals in assigned functional area of Human Resources (such as Benefits, HR Help Center, Payroll,...

  • Principal AR Specialist, Human Resources

    7 days ago

    Ayala Alabang, National Capital Region, Philippines Capital One Full time ₱900,000 - ₱1,200,000 per year

    Alabang , Philippines, Muntinlupa City, National Capital Region (Manila)Principal AR Specialist, Human Resources Summary:To assist the Principal HR Specialist, supervise HR coordinators, and manage and ensure day-to-day operations meet standards and achieve goals in assigned functional area of Human Resources (such as Benefits, HR Help Center, Payroll,...

  • Urgent Account Receivable Follow up

    4 days ago

    Ayala Alabang, National Capital Region, Philippines Addforce Human Resources Solution Inc. Full time ₱480,000 - ₱720,000 per year

    Position: Accounts Receivable AssociateLocation: Alabang Corporate Center, Alabang, Muntinlupa CityWork Set Up & Schedule: Onsite & US Shift ( Night Shift)Salary: 40,000Qualifications:Graduate of any college degree.Must have 2+ years in a Healthcare BPO settingKnowledge of commercial, HMO, Medicare/Medicaid, and other payer requirements.Working knowledge...

  • AR Associate

    4 days ago

    Ayala Alabang, National Capital Region, Philippines Acro Distribution and Network Inc Full time ₱300,000 - ₱450,000 per year

    Qualifications:Graduate of any Business related courseComputer literateKnowledgeable in MS ExcelWith working experience as AR is a PLUSFresh Graduate are welcome to apply.Within an Accounts Receivable role, they will need to possess the following skills:Ability to prioritize and manage expectations.A keen eye for details.Must have a sense of responsibility...

  • Senior Team Lead, Medical AR

    4 days ago

    Ayala Alabang, National Capital Region, Philippines Gear Inc. Full time $90,000 - $120,000 per year

    About the job Senior Team Lead, Medical AR & Denial ManagementThe Senior Team Lead (STL) is expected to mentor team leaders, manage escalations, guide productivity, and help improve operational workflows based on data insights and volume trends. They serve as a key link between operations, quality, training, and client-facing functions.RESPONSIBILITIESLead,...

  • Accounts Receivable

    4 days ago

    Ayala Alabang, National Capital Region, Philippines GECO Asia Pte. Ltd Full time ₱1,200,000 - ₱2,400,000 per year

    JOB SUMMARYThe Specialist supports the Process Senior Specialist/Team Leader. The role will support the Finance function and is responsible for undertaking accounting activities for assigned entities. In summary, the role involves day-to-day management of Accounts Receivable ledgers, ensuring accuracy and integrity. The employee may also be required to...

  • Accounts Receivable Specialist

    2 days ago

    Ayala Alabang, National Capital Region, Philippines NYGC Services, Inc. Full time ₱900,000 - ₱1,200,000 per year

    Role : AR SpecialistLocation : Alabang MuntinlupaWork Type : HybridWork Shift : 2PM-11PMJob Description:CPA with at least 5 years' experience in the role is preferredNeeds at least 3 years background in Accounts Receivable functions, please look for candidates with experience in cash application / posting customer payments. I. JOB SUMMARY: (Brief...