Medical Claims Analyst: Claims Recovery & Billing Pro

MED-METRIX INTERNATIONAL PH-I, INC.; Pasig; On-site; PHP 312,000 - 402,000; Full time

Benefits offered by this job

8-Hour Shifts, Fixed Weekends Off

Day 1 HMO with 2 dependents covered

Group Life Insurance

Medical Cash Allowance

Rice Allowance

Clothing Allowance

Holiday Gift

Bereavement Assistance

Free Lunch Daily

Paid Time Off

Training and Staff Development

Employee Engagement Activities

Opportunities for Internal Mobility

Job summary

Med-Metrix International PH-I, Inc. in Pasig is seeking a Medical Claims Analyst to manage collections, account follow-up, billing and allowance posting for assigned accounts.

You will follow up with payers, meet productivity standards, and use client systems to resolve balances efficiently. The role requires 1+ year in healthcare AR/collections, experience with US healthcare, and a mix of back-office tasks with outbound calls.

Qualifications

• Minimum 1 year of Healthcare Account Receivable/Collections in a BPO setting or environment (claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers) and at least 1 year US healthcare - Medical/Healthcare Insurance experience.
• Amenable to handling a mixture of 70% back-office support and 30% outbound call support.
• Experienced on medical billing/ AR Collections
• Must have an experience processing workers compensation benefits.

Responsibilities

• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
• Meets and maintains daily productivity/quality standards established in departmental policies
• Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
• Adheres to the policies and procedures established for the client/team
• Knowledge of timely filing deadlines for each designated payer
• Performs research regarding payer specific billing guidelines as needed
• Ability to analyze, identify and resolve issues causing payer payment delays
• Ability to analyze, identify and trend claims issues to proactively reduce denials
• Communicates to management any issues and/or trends identified
• Initiate appeals when necessary
• Ability to identify and correct medical billing errors
• Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
• Understanding of under or over payments and credit balance processes
• Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required
• Act cooperatively and courteously with patients, visitors, co-workers, management and clients
• Work independently from assigned work queues
• Maintain confidentiality at all times
• Maintain a professional attitude
• Other duties as assigned by the management team
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Understand and comply with Information Security and HIPAA policies and procedures at all times
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Skills

Healthcare AR/Collections

US Healthcare Experience

Outbound Calls

Communication Skills

Job description

Med-Metrix International PH-I, Inc. in Pasig is seeking a Medical Claims Analyst to manage collections, account follow-up, billing and allowance posting for assigned accounts.

You will follow up with payers, meet productivity standards, and use client systems to resolve balances efficiently. The role requires 1+ year in healthcare AR/collections, experience with US healthcare, and a mix of back-office tasks with outbound calls.