Project Manager, Supply Chain Planning
Cummins Inc.
Medical Billing Specialist, Collections
Sourcefit
full-time
Posted on:
Origin: • 🇵🇭 Philippines
Visit company websiteJob Level
JuniorMid-Level
About the role
- Perform verification of eligibility and benefits to ensure accurate patient coverage
- Review and submit claims in a timely and compliant manner
- Obtain prior authorizations to support claim approvals
- Monitor the status of medical claims and conduct A/R follow-up to ensure prompt and accurate payment
- Research and resolve claim rejections and denials and implement measures to prevent recurrence
- Generate and submit patient statements (no patient interaction)
- Document all account activities accurately and in a timely manner
- Post manual payments, apply adjustments, and manage collections from various payers
- Correctly record contractual adjustments based on payer contracts and government regulations
- Exhibit proficiency with billing systems to ensure efficient claims processing
- Maintain up-to-date knowledge of changes in billing and coding guidelines, payer contracts, and government regulations
- Collaborate with team members and providers to foster a positive and productive work environment
Requirements
- At least 2 years strong background in end-to-end revenue cycle processes including eligibility and benefits verification, charge review, claims submission, AR follow-up and denial management, collections, prior authorizations, payment posting, and handling medical records requests
- Experience with Medicare, Medicaid, Medicaid Managed Care, commercial insurance, and Workers' Compensation
- Knowledge of eligibility requirements, payment methodologies, and recording contractual adjustments in compliance with government regulations and payer contracts
- Proficiency with billing systems and ability to leverage system functionality
- Experience in DME and using Apero preferred
- Ability to work collaboratively with team members and healthcare providers
- Ability to function in a fast-paced work environment and handle occasional periods of above-average pressure
- Excellent customer service skills and ability to interact with patients, insurance companies, and healthcare providers
- Must be able to work the Manila Time night shift (10:00 PM to 7:00 AM)
