Payment Review 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

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.