Healthcare Claims Representative

Details of the offer

This role is responsible for processing insurance and/or payment refunds to resolve credit balances on customer accounts.
**RESPONSIBILITIES**:
Ø Reviews credit balance and contacts the insurance in order to determine if refund due to the insurance or customer is valid.
Ø Submits refund, adjustments or write-off, or (patient) payment transfer requests with complete supporting documents as necessary for approval to resolve outstanding credit balances.
Ø Maintains accurate and detailed notes/documentation in applicable systems.
Ø Keeps Supervisor and/or Manager informed of system issues.
Ø Observes legal and ethical guidelines for safeguarding patient and company confidentiality (HIPAA).
Ø Other duties as assigned.
**BASIC QUALIFICATIONS | EDUCATION**:
Ø Completed at least 2 years in College or with an Associate or Bachelor's Degree

Ø Excellent oral and written communication skills

Ø Thorough understanding of the US Healthcare Insurance claims

**PREFERRED QUALIFICATIONS**:
Ø Proficient Medicare and solid general payer knowledge

Ø Has the ability to read and interpret explanation of benefits

Ø Basic Excel, Word and Outlook experience required

Ø Typing using computer keyboards, 10-key pads and calculators

Ø Strong Computer/Software Skills

Ø Detail-oriented

Ø Typing speed of 35 wpm

Ø Occasional weekend work may be required

Ø Must be flexible to work on a night shift (between 6pm to 10am) Philippine Standard Time.
Ø Must be amenable to work on Overtime or during Rest Days when business requests for additional (paid) hours

**COMPETENCIES**:
Ø Internal - At least 1 years tenure in ACH Revenue Cycle

Ø External - 1 year of experience in Healthcare Insurance Collections and/or Correspondence

**Job Types**: Full-time, Permanent

**Salary**: Php25,000.00 per month

Schedule:

- 8 hour shift
- Night shift

**Experience**:

- healthcare claims insurance: 2 years (required)
- Customer Support: 2 years (required)
- US Healthcare Insurance Claims: 2 years (required)


Nominal Salary: To be agreed

Source: Whatjobs_Ppc

Job Function:

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