Accounts Receivable Specialist
Full-time
AddForce Human Resources Solution Inc.
Requirements:
- Graduate of any college degree.
- Must have 2+ years in a Healthcare BPO setting
- Knowledge of commercial, HMO, Medicare/Medicaid, and other payer requirements.
- Working knowledge on the use of insurance payer websites ie: Availity, Optum, Medicare, Evicore portals.
- Working knowledge with Practice Management systems, preferably KAREO a plus.
- Effective communication abilities
- Proven problem-solving skills
- Proficient knowledge of medical terminology is likely to be encountered in medical claims denials.
- Amenable to work onsite during training and nesting period in Alabang, Muntinlupa City and US shifts
Responsibilities
- Monitor outstanding accounts to ensure timely collection of payments.
- Maintain accurate aging reports for all outstanding invoices.
- Prioritize accounts based on age, value, or client-specific requirements.
- Follow-Up on Outstanding Claims/Invoices
- Contact insurance companies, clients, or customers via phone, email, or portals to check claim status or payment status.
- Identify delays, denials, or issues affecting payment.
- Document all follow-up actions in the system.
- Denial Management & Resolution
- Investigate claim denials and underpayments.
- Work with billing teams to correct and resubmit claims.
- Appeal denied claims with proper documentation when necessary.
- Payment Posting Support
- Coordinate with payment posting teams to verify payment accuracy.
- Resolve discrepancies between posted payments and expected reimbursements.
- Communication & Coordination
- Collaborate with billing, coding, and customer service teams to resolve issues.
- Communicate with insurance providers or clients to clarify requirements or missing information.
- Customer Service
- Provide clear and respectful communication to clients or insurers.
- Address inquiries related to billing or outstanding balances.
- Process Improvement
- Identify frequent denial trends or process bottlenecks.
- Suggest improvements to reduce AR days and denial rates.
Vacancy posted 6 hours ago
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