Medical Billing Service jobs in Manila

Position Overview:

The Revenue Cycle Specialist - Insurance Verification and Authorization is a key member of the healthcare revenue cycle team, responsible for ensuring that patients' insurance coverage is accurately verified and securing necessary authorizations for medical services in accordance with each insurance provider’s guidelines. This role is crucial for minimizing delays and denials, optimizing reimbursement, and enhancing the patient experience. The specialist will collaborate closely with clinical staff, billing departments, and insurance companies to facilitate smooth and efficient processing of insurance information.

Work setup: Onsite @ San Juan City, Metro Manila

Schedule: Night shift

Key Responsibilities:

• Insurance Verification:
• Verify patients' insurance coverage and benefits for scheduled admissions and services.
• Accurately enter and update insurance information in the healthcare system.
• Communicate with insurance companies to confirm coverage details and resolve discrepancies.
• Reverify patients’ insurance coverage and benefits each plan or calendar year
• Authorization Requests:
• Obtain prior authorizations and pre-certifications for services as required by insurance payers.
• Ensure that all necessary clinical documentation and information are submitted to support authorization requests.
• Follow up on pending authorizations to ensure timely approval and prevent service delays.
• Ensures the timely and appropriate maintenance of authorization extensions for all patients.
• Communication:
• Inform appropriate parties about patient’s insurance coverage, out-of-pocket costs, and any authorization requirements.
• Assist patients in understanding their insurance benefits and address any questions or concerns they may have.
• Provide excellent customer service to ensure a positive patient experience.
• Build and maintain good and professional relationships with insurance companies and their Case Managers.
• Coordination and Collaboration:
• Work closely with operations team to ensure all necessary information is obtained for verification and authorization.
• Collaborate with other Revenue Cycle departments and Payer Relations teams to address any issues related to insurance coverage and authorizations.
• Serve as a liaison between the healthcare provider and insurance companies to resolve any verification or authorization issues.
• Perform other functions necessary to ensure financial clearance.
• Reporting and Documentation:
• Maintain accurate and detailed records of all insurance verification and authorization activities.
• Generate reports on verification and authorization status, identifying any trends or issues that need to be addressed.
• Ensure compliance with all regulatory requirements and internal policies related to insurance verification and authorization.
• Process Improvement:
• Identify opportunities to streamline and improve the insurance verification and authorization process.
• Participate in team meetings and contribute to discussions on process enhancements and best practices.
• Stay informed about changes in insurance policies, authorization requirements, and industry standards.

Experience:

• Minimum of 1 years of experience in healthcare insurance verification, authorization requests, or a related revenue cycle role preferred.
• High school diploma or equivalent required; Associate’s or Bachelor’s degree in a related field preferred.
• Strong understanding of insurance plans, benefits, and authorization processes.
• Understanding of medical terminology and clinical documentation.
• Excellent communication and interpersonal skills.
• Attention to detail and strong organizational skills.
• Proficiency in healthcare billing software and electronic health records (EHR) systems.
• Ability to prioritize and manage multiple tasks simultaneously, and to effectively anticipate and respond to issues as needed in a dynamic work environment.
• Ability to work independently and as part of a team.

What’s in it for you?

-Competitive Salary!

-Weekly payout!

-HMO for you and 1 Dependent

-Medical and Dental coverage, and Life insurance

- Holiday Pay and 13th Month

- up to 20 Paid Time off Days

- 10% Night Differential

-Onsite work at our brand-new facility

-Company events

-Free parking and many more...

Pay: Php50,000.00 - Php57,000.00 per month

Work Location: In person