billing Operations specialistGenfinity

A Billing Operations Specialist main responsibility is to facilitate and monitor all revenue generating areas for MedRisk. This critical role requires the individual to evaluate and confirm compensability and eligibility on worker's compensation claims to ensure they are in compliance with MedRisk's company directives, treating provider contracts, jurisdiction state rules, and client specified procedures/guidelines.
Primary Duties and Responsibilities:
· Perform complex billing, claim processing, and reimbursement type job functions
· Review bills to determine eligibility for processing
· Validate existing data for accuracy and completeness and make outbound calls to providers and clients as needed to obtain critical information and/or verify compensability
· Perform a variety of administrative duties as assigned
· Provide excellent and professional customer service to external and internal customers
· Open communication with vendors and/or clients for optimization of bill acceptance and collections
· Ensure SLAs and TATs are constantly being met
· Maintain strong working knowledge of various Revenue Operations workflows for regular assistance of other department tasks
· Work special priority projects as assigned within established turnaround times
· Complete other duties and projects as assigned
Qualifications:
· Must possess a bachelor's degree in any field
· Minimum 1-2 years of experience in the BPO (Healthcare) industry preferred
· Experience handling inbound or outbound calls is a plus, but not required
· Preferably with knowledge on the US Healthcare system, particularly with HIPAA regulations and compliance
· Prior experience in medical billing or in a health-related field with some knowledge of insurance and/or medical terminology/coding (i.e. CPT/HCPCS and ICD) preferred
· Excellent verbal and written communication skills
· Proficient in MS Word and Excel and general computer literacy, working with dual screens
· Organizational skills, prioritization, problem-solving and decision-making skills are required
· Ability to multi-task in a fast-paced environment
· Strong analytical and interpersonal skills are also required
· Willing to work any assigned shift during the week in Mandaluyong City
Genfinity

Mandaluyong City, Metro Manila
₱30,000 per month
Permanent
Full-time