CSR- Accounts Receivable

Global Healthcare Billing Partners; Muntinlupa; On-site; PHP 201,000 - 312,000; Full time

Job summary

Global Healthcare Billing Partners in Manila is seeking an experienced healthcare claims professional to manage end-to-end processing, from receipt to adjudication and payout. The role emphasizes accuracy, timely submissions, and adherence to privacy rules.

You will specialize in behavioral health claims, ensure proper coding with ICD-10, CPT, HCPCS, and collaborate in a high-volume BPO environment.

Qualifications

• Experience in end-to-end healthcare claims processing, denial management or appeals.
• Hands-on experience in a BPO setting.
• Strong communication skills and detail orientation.

Responsibilities

• Oversee the entire lifecycle of medical claims from receipt to payout.
• Handle behavioral health claims with correct coding and documentation.
• Audit submissions for accuracy to ensure HIPAA and CMS compliance.
• Verify patient benefits in real time to prevent delays, especially for mental health benefits.

Skills

Verbal and written communication

Attention to detail

Independent and collaborative work

Job description

Key Responsibilities

• Comprehensive Claims Management: Oversee the entire lifecycle of medical claims, from initial receipt and adjudication through to final resolution, appeal, or payout.
• Behavioral Health Specialization: Manage complex claims specific to behavioral and mental health services, ensuring accurate alignment with specialized coding and documentation standards.
• Quality Assurance & Compliance: Audit submissions for accuracy and policy alignment, ensuring full compliance with payer guidelines, HIPAA, and CMS regulations.
• Real-Time Verification: Validate patient benefits and coverage eligibility swiftly to prevent processing delays, particularly regarding mental health benefits.

Required Qualifications

• Experience: Minimum of 1 year of hands-on experience in end-to-end healthcare claims processing, denial management, appeals, or claims analysis specifically within a BPO setting.
• Technical Knowledge: Solid understanding of medical coding systems (ICD-10, CPT, HCPCS), diverse claim types, and industry-standard regulations (HIPAA, CMS, etc.).
• Core Skills: Strong verbal and written communication abilities, a sharp eye for detail, and the flexibility to thrive both independently and collaboratively in a high-volume environment.