Medicare Payment & Refund Specialist

Abbott Laboratories; Taguig; On-site; PHP 420,000 - 600,000; Full time

Job summary

Abbott Laboratories in Taguig, Philippines seeks a Payment Review Specialist to process Medicare, commercial and patient refunds, resolving under- and over-payments. You will interact with Medicare claims, prepare refund forms, and ensure accurate posting and documentation.

Strong attention to detail and HIPAA-compliant communication are required. The role emphasizes accuracy in billing, timely resolutions, and collaboration across departments to maintain patient and company confidentiality

Qualifications

• Medical billing knowledge and coding language skills.
• Thorough understanding of claims reimbursement processes, including denials and cash posting.
• Proficient Medicare and solid general payers' knowledge.
• Strong research, review, and analysis skills.
• Understanding of physician diagnosis choices and application of appropriate billing codes.
• Knowledge of medical terminology, anatomy, and disease treatments.
• Strong reading and data entry typing skills.
• Excellent attention to detail and accuracy in data entry and billing activities.
• Strong written and oral communication skills.
• Ability to interact effectively with medical personnel, insurance companies, and patients via phone and email.
• Active listening and note-taking skills.
• Technology skills including basic office equipment operation and proficiency with word processing and spreadsheet software.
• High school diploma or GED required.
• Associate degree preferred.
• Preferred years of experience: Level I 1 to 3 years; Level II 3 to 5 years.
• Excellent verbal and written communication skills, including the ability to effectively communicate with internal and external customers.
• Excellent computer proficiency (MS Office: Word, Excel, and Outlook).
• Ability to work under pressure and meet deadlines while maintaining a positive attitude and providing exemplary customer service.
• Ability to work independently and carry out assignments to completion within prescribed routines, instructions, and standard accepted practices.

Responsibilities

• Evaluate patient accounts for payment status against refunds.
• Resolve invoice under payments and over payments in a timely manner.
• Communicate with Medicare directly to assess claims.
• Fill out refund forms for accounting for check requests.
• Credit accounts when necessary and mail original backups.
• File all documents in appropriate areas.
• Comply with State, Federal, professional regulations and department rules.
• Respond promptly to calls, correspondence and faxes.
• Verify payments received are correct according to the fee schedule.
• Apply payments correctly to patient accounts, including Medicare auto posting.
• Keep Supervisor and Manager informed of payment and denial trends.
• Read and interpret an Explanation of Benefits.
• Meet all month-end requirements.
• Maintain proficiency in equipment and services offered by the company.
• Observe HIPAA confidentiality and provide exceptional customer service.
• Interact professionally with teammates and customers.
• Promote company culture by adhering to policy and mission.
• Complete assigned work timely and efficiently.
• Adapt to frequent changes in the work environment.
• Meet individual, departmental, and company goals.
• Perform other duties as assigned.

Skills

Medical billing

Data entry

MS Office

Communication skills

Analytical thinking

HIPAA knowledge

Customer service

Education

High school diploma or GED

Associate degree

Tools

Billing software

Excel

Job description

Abbott Laboratories in Taguig, Philippines seeks a Payment Review Specialist to process Medicare, commercial and patient refunds, resolving under- and over-payments. You will interact with Medicare claims, prepare refund forms, and ensure accurate posting and documentation.

Strong attention to detail and HIPAA-compliant communication are required. The role emphasizes accuracy in billing, timely resolutions, and collaboration across departments to maintain patient and company confidentiality