As a **Resolution Specialist (Claims) **supporting the communication between internal and external customers, you will report to the Director of Operations to help strengthen MedRisks issue resolution process ensuring efficient processes while increasing customer satisfaction.
You will monitor multiple provider locations to ensure bills related to prospective and retrospective cases and billed through the life of the claim.
**Essential Responsibilities & Duties**:
- Analyze and review cases that have been scheduled but Medrisk has not received bills.
- Analyze and review retrospective cases to determine if bills match the number of visits authorized.
- Independently determine the cause and provide the cure to the provider related to missing bills.
- Based on analysis communicate trends in missing bills to Sr. Issue Resolution Specialist and Director of Operations.
- Effectively document actions and results providing clear and concise written notes in system of record.
- Communicate known issues with all internal Revenue Operations, Finance, Account Management, Provider Relations, and Customer Service Center departments.
**Qualifications**
- Experience with MedManager, Quattro and/or other billing websites, and dashboards strongly desired.
- Experience in fully researching and resolving billing issues, multiple payers strongly preferred.
- Knowledge of medical terminology; CPT, HCPC, ICD9/10 codes for physical medicine.
- Understanding of state Workers Compensation laws and statutes.
- Basic comprehension of HIPPA policies and procedures.
- MS Office Products; Word, Excel, and Outlook experience.
- Willing to in Mandaluyong City
- Willing to work on night shift
**Job Types**: Full-time, Permanent
**Salary**: Php32,000.00 - Php35,000.00 per month
**Benefits**:
- Additional leave
- Company Christmas gift
- Company events
- Health insurance
- Paid training
Schedule:
- 8 hour shift
- Shift system
Supplemental Pay:
- 13th month salary
- Overtime pay
Ability to commute/relocate:
- Mandaluyong City: Reliably commute or planning to relocate before starting work (required)