Reimbursement Specialist (Healthcare | ONSITE - Ortigas + 25% Night Differential)

Connext; Pasig; Hybrid; PHP 2,642,000 - 4,088,000; Full time

Benefits offered by this job

Competitive compensation

Perfect Attendance Bonus

Life insurance

HMO Insurance

Great company culture

Annual Merit Increase

25% Night Differential

Job summary

Connext Global Solutions in the Philippines is seeking a Reimbursement Specialist to support a United States client. You will research, analyze, and negotiate pre- and post-payment proposals to maximize reimbursement outcomes and ensure accurate claims processing.

Ideal candidates have at least two years in payment/reimbursement negotiation, strong English communication, and solid analytical skills. You will handle follow-ups via calls and emails, and escalate complex cases to the onshore

Qualifications

• Strong analytical skills with ability to identify discrepancies and determine solutions.
• Time management skills and ability to handle multiple claims.
• Clear and coherent written and verbal communication in English.

Responsibilities

• Research and negotiate pre- and post-payment proposals on a daily basis.
• Analyze claims, reimbursement rates, and supporting information to determine negotiation positions.
• Review proposed negotiations and identify opportunities to maximize reimbursement outcomes.
• Make outbound calls to follow up on negotiation proposals and ensure responses are reviewed.
• Handle negotiation-related follow-ups through phone calls, emails, and other communication channels.

Skills

Analytical skills

Time management

English communication

Negotiation

Education

High school diploma

Job description

Connext Global Solutions is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.

We are currently looking for an Reimbursement Specialist who will be working with Connext's Client in the United States of America.

What's in it for you?

• Competitive compensation
• Perfect Attendance Bonus
• Life insurance
• HMO Insurance
• Great company culture
• Annual Merit Increase
• 25% Night Differential

What is the job?

The Reimbursement Specialist is responsible for researching, analyzing, and negotiating pre- and post-payment proposals to maximize reimbursement outcomes. The role reviews claims and reimbursement information, manages negotiation follow-ups, documents negotiation activities, and escalates complex claims to the onshore Negotiations team when additional guidance is needed.

• Research and negotiate pre- and post-payment proposals on a daily basis.
• Analyze claims, reimbursement rates, and supporting information to determine appropriate negotiation positions.
• Review proposed negotiations and identify opportunities to maximize reimbursement outcomes.
• Make outbound calls to follow up on negotiation proposals and ensure responses are reviewed.
• Handle negotiation-related follow-ups through phone calls, emails, and other communication channels.

Required Qualifications:

• High school diploma or equivalent combination of education and relevant work experience.
• Minimum of two (2) years of experience in payment/reimbursement negotiation, claims management, medical billing, or healthcare revenue cycle management.
• Must have stable employment history.
• Experience analyzing claims and reimbursement information.
• Proven ability to evaluate reimbursement rates and negotiate payment proposals.
• Proven ability to conduct productive discussions and secure appropriate reimbursement outcomes.
• Proven ability to create and follow action plans to achieve required outcomes.
• Proven ability to handle sensitive payment information while maintaining confidentiality and security.
• Demonstrates strong analytical skills with the ability to identify discrepancies and determine appropriate solutions.
• Demonstrates strong time-management skills and ability to manage multiple claims simultaneously.
• Clear and coherent both written and verbal communication skills in English.