Strategic Healthcare AR Specialist - Denials & Payments

AddForce Human Resources Solution Inc.; Muntinlupa; On-site; PHP 279,000 - 390,600; Full time

Job summary

A leading human resources solution provider in Metro Manila is seeking a dedicated professional to handle healthcare claims management. This role requires at least 2 years of experience in a Healthcare BPO setting, strong communication abilities, and knowledge of insurance payer requirements. Responsibilities include monitoring outstanding accounts, managing denial resolutions, and ensuring timely payment collections. Candidates must be amenable to onsite work in Alabang, Muntinlupa City and understand the needs of various insurance entities.

Qualifications

• Must have 2+ years of experience in a Healthcare BPO setting.
• Knowledge of commercial, HMO, Medicare/Medicaid, and other payer requirements.
• Proficient knowledge of medical terminology encountered in medical claims denials.

Responsibilities

• Monitor outstanding accounts to ensure timely collection of payments.
• Maintain accurate aging reports for all outstanding invoices.
• Contact insurance companies, clients, or customers to check claim status or payment status.
• Investigate claim denials and underpayments.
• Provide clear and respectful communication to clients or insurers.

Skills

Effective communication abilities

Proven problem-solving skills

Education

Graduate of any college degree

Tools

KAREO

Availity

Optum

Medicare

Evicore portals

Job description

A leading human resources solution provider in Metro Manila is seeking a dedicated professional to handle healthcare claims management. This role requires at least 2 years of experience in a Healthcare BPO setting, strong communication abilities, and knowledge of insurance payer requirements. Responsibilities include monitoring outstanding accounts, managing denial resolutions, and ensuring timely payment collections. Candidates must be amenable to onsite work in Alabang, Muntinlupa City and understand the needs of various insurance entities.