Healthcare support specialist | earn up to 30k*Tahche Outsourcing Services Inc.

Our US partner is one of the leading Medical Digital Imaging Service Providers in New Jersey. They offer a full spectrum of diagnostic imaging services in comfortable, convenient, and friendly outpatient imaging centers.
 
As a Healthcare Support & Pre-Certification Specialist, you will play a dual role in providing front-desk and billing support while also managing pre-certification and insurance verification tasks. This position is essential in ensuring accurate, timely, and patient-centered service - from scheduling appointments and assisting patients, to handling billing inquiries and securing insurance authorizations.
 
This is a full-time role, on a US shift and with an Onsite set-up.
If you have the right skill set, this may be your opportunity to enter this fast-growing organization.
 
DUTIES AND RESPONSIBILITIES:
 
Front Desk & Patient Coordination
Handle inbound calls and assist patients with inquiries or concerns.
Schedule and confirm patient appointments.
Make outbound calls to remind patients of procedures and share preparation instructions.
Collect, verify, and update patient information; process faxed documents.
Escalate urgent or complex concerns to the appropriate party.
Maintain accurate patient account information.
Billing Support & Payment Processing
Manage inbound/outbound calls related to billing from patients, insurance providers, and legal/medical offices.
Update billing systems with verified patient and payer data.
Process payments and ensure accurate posting to billing software (e.g., GVT, Trizetto).
Follow up on accounts receivable, assist in generating invoices, and correct billing discrepancies (e.g., coding or charge errors).
Ensure all billing actions comply with HIPAA standards and company policies.
Pre-Certification & Insurance Verification
Monitor the Radiology Worklist daily and prioritize cases.
Obtain pre-certifications and pre-authorizations for procedures and medications.
Contact insurance companies for verification, referrals, and authorizations.
Create cases in eviCore or other insurance portals.
Request and review additional clinicals to ensure compliance with insurance guidelines.
Track pending cases, follow up on approvals or denials, and escalate as needed.
Notify providers or medical assistants about pending/denied cases.
Take appropriate action on cases requiring additional documentation, CPT recommendations, or other follow-ups.
Other
Perform ad hoc tasks as assigned by supervisors or managers.
QUALIFICATIONS:
At least 1 year of BPO experience in a healthcare-related account is required.
Proven experience in appointment scheduling, front office/back office support, billing coordination, and/or obtaining pre-authorizations in a healthcare environment.
Familiarity with US healthcare systems and tools (e.g., GVT, Trizetto) is an advantage.
Knowledge of CPT, ICD, DX, and HCPCS billing codes is highly preferred.
Experience in radiology accounts, digital imaging centers, or claims processing is a plus.
HIPAA training or certification is required.
Strong communication and multitasking skills with keen attention to detail.
WHAT'S IN IT FOR YOU? (Be part of a Dynamic US Team!)
Experience work-life balance while working the night shift with weekends off rest days
Full-time permanent position
Competitive base salary with allowance
13th-month pay
Paid Leaves and Service Incentive Leaves
Health insurance with dental coverage upon regularization, with the opportunity for an additional 2 dependents
We cover Government-mandated benefits (SSS, Phil health, Pag Ibig, Maternity or Paternity leave benefit, Solo Parent Leave, etc.)
Participate in a variety of activities, including team outings, sports events, and other fun events to foster camaraderie.
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Apply now and be part of Tahche!
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