Payment Review Specialist

Abbott; Taguig; On-site; PHP 200,000 - 320,000; Full time

Job summary

Abbott is seeking a Payment Review Specialist in the Philippines (Taguig) to process Medicare, commercial and patient refunds and resolve under-payments and over-payments with precision and timeliness.

You will fill refund forms, post payments to accounts, and communicate with Medicare, ensuring documentation is accurate and compliant with HIPAA and company rules. This role supports Abbott's HF division in a global healthcare leadership position.

Qualifications

• Knowledge of medical billing and reimbursement workflows.
• Understanding of claims denial resolutions and cash posting.
• Familiarity with Medicare rules and payer policies.
• Proficiency in interpreting Explanation of Benefits.
• Strong accuracy in data entry and documentation.

Responsibilities

• Evaluate and process patient refunds and payments.
• Resolve under-payments and over-payments promptly.
• Communicate with Medicare to assess claims.
• Fill out refund forms and mail back-ups.
• Apply payments accurately to patient accounts and adjust as needed.
• Maintain and file documentation in proper areas.
• Ensure compliance with HIPAA and company policies.
• Provide excellent customer service to internal and external customers.
• Meet month-end requirements and deadlines.

Skills

Medical billing knowledge

Claims reimbursement processes

MS Office (Word, Excel, Outlook)

Communication skills

Attention to detail

Data entry

Ability to work under pressure

Medicare familiarity

Education

High school diploma or GED

Associate degree preferred

Tools

Medicare claims processing system

Job description

JOB DESCRIPTION:

Payment Review Specialist

Abbott is a global healthcare leader, creating breakthrough science to improve people’s health. We’re always looking towards the future, anticipating changes in medical science and technology.

In Abbott’s Heart Failure (HF) business, we’re developing solutions to diagnose, monitor and manage heart failure, allowing people to restore their health and get on with their lives.

Working at Abbott

At Abbott, you can do work that matters, grow, and learn, care for yourself and family, be your true self and live a full life. You will have access to:

• Career development with an international company where you can grow the career you dream of.
• A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune.
• A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists.

The Opportunity

As the Payment Review Specialist , you will process all Medicare, commercial and patient refunds, while resolving invoice under-payments and over-payments.

What You’ll Do

• Evaluate patient accounts for payment status (i.e., who, what, amount paid) against what was returned and what is being refunded.
• 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 request.
• Credit accounts when necessary, make copies of documents and mail original back-ups along with check to Medicare.
• File all documents (back-up copies) in appropriate areas.
• Comply with all State, Federal, professional regulations as well as department rules, policies and procedural information.
• Respond promptly when returning telephone calls and replying to correspondence and faxes.
• Verify that payments received are correct according to the fee schedule.
• Apply payments correctly to assigned patient accounts, including Medicare auto posting checks, patient cash, and adjustments as needed.
• 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 the knowledge of equipment and services offered by the company.
• Work as part of the company team by communicating effectively with all departments.
• Observe legal and ethical guidelines for safeguarding patient and company confidentiality (HIPAA).
• Provide exceptional customer service to both internal and external customers.
• Interact in a professional manner with all teammates and customers.
• Promote the company culture by adhering to policy, procedure, and mission statement.
• Complete assigned work in a timely and efficient manner.
• Adapt to frequent changes in the work environment.
• Meet individual, departmental, and company goals.
• Perform other duties as assigned.

Requirements

• Medical insurance 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.

Location

This position is based in Philippines. Five Neo Building, Taguig City

Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity.

Connect with us at www.abbott.com, on Facebook at www.facebook.com/Abbott and on Twitter @AbbottNews and @AbbottGlobal.

The base pay for this position is

N/A

In specific locations, the pay range may vary from the range posted.

JOB FAMILY

Accounts Payable & Receivables, Credit & Collection, & Payroll

DIVISION

HF Heart Failure

LOCATION

Philippines > Taguig City : Five/Neo Building

WORK SHIFT

Standard

TRAVEL

Not specified

MEDICAL SURVEILLANCE

Not Applicable

SIGNIFICANT WORK ACTIVITIES

Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day)