Medical Claims Processing jobs

Position Overview

The Pre-AR Specialist is responsible for managing the end-to-end pre-AR process, ensuring patient accounts are accurately prepared and ready for billing. This includes patient registration, charge entry, reviewing and validating patient and insurance information, identifying and resolving account discrepancies, and ensuring all required documentation and charges are complete and accurate prior to billing.The role requires strong attention to detail and a solid understanding of medical terminology, healthcare revenue cycle processes, insurance information, and billing requirements to help prevent claim errors, delays, and downstream AR issues.

Key Responsibilities

• Resolve charge entry errors and discrepancies to ensure charges are accurately processed and submitted to the appropriate insurance payer for reimbursement.
• Update and maintain patient registration and insurance information, ensuring accurate and complete coverage details.
• Review and select the correct insurance payer and billing information to support accurate claim submission, maximize reimbursement, and prevent denials.
• Review patient accounts and verify insurance eligibility and benefits through payer portals, OneSource, Availity, and direct calls to insurance payers when necessary.
• Review and resolve Coordination of Benefits (COB) issues to ensure claims are billed to the appropriate primary and secondary payers.
• Review and address claim edits and billing-related discrepancies prior to claim submission to minimize errors, rejections, and payment delays.
• Ensure patient accounts are complete, accurate, and billing-ready throughout the pre-AR process.

Qualifications:

• At least 2 years of experience in the US healthcare industry, preferably in Revenue Cycle Management (RCM), with working knowledge of insurance and benefits.
• Prior experience using EPIC is required.
• Knowledge of medical terminology
• Proficient in Microsoft Office applications.

Technical Requirements:

• Own desktop or laptop (Core i5 or higher to serve as a backup device)
• Primary internet connection with a minimum speed of 50 Mbps.
• Secondary internet connection to serve as a backup.

Other Details:

• Independent Contract
• Permanent WFH
• Graveyard shift (Central Time)
• Equipment provided (Desktop computer)

Pay: Php45,000.00 - Php50,000.00 per month

Application Question(s):

• Have you worked in Revenue Cycle Management (RCM)?
• Do you have experience with Epic?

Experience:

• US Healthcare: 2 years (Required)

Work Location: Remote