Medical Account Bpo jobs in Ortigas

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

• 1 year of experience in the BPO healthcare insurance industry, with hands on experience on Accounts Receivable (AR) follow-up
• Proficient in processing health and medical insurance claims from end to end with an understanding of payer-specific requirements and denials management and processing.
• Experienced on medical billing/ AR Collections
• In-depth knowledge on claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers.
• Familiar with key healthcare and insurance terminologies including copay, coinsurance, and deductibles.
• Amenable to handling a mixture of 70% back-office support and 30% outbound call support
• 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

Job Type: Full-time

Pay: From Php33,000.00 per month

Benefits:

• Employee discount
• Health insurance
• Opportunities for promotion
• Paid training
• Promotion to permanent employee

Education:

• Bachelor's (Preferred)

Experience:

• Healthcare: 1 year (Required)
• Medical Claims: 1 year (Required)

Language:

• English (Required)

Work Location: In person