Vector Outsourcing Solutions Philippines

Analyst

• Work closely with Operations in collecting crucial data produced by the staff
• Create reports and analyze data for Management's use
• Together with the Report Writing team, explore and develop other methods to improve staff's/operations' performance
• Maintain monthly reports of Management related to performance/manpower
• Help out in other data-related tasks from Management

Reports Analyst

Medical Billing and Coding

• Supervise and lead a team of medical billing specialists, providing guidance, training, and support as needed
• Communicate and facilitate special projects, reports, and requests from client
• Assign tasks, set priorities, and monitor performance to ensure productivity and accuracy
• Develop and improve billing policies, procedures, and workflows to optimize efficiency
• Review and approve billing documents, ensuring compliance with coding guidelines and regulatory standards
• Manage accounts receivable, tracking outstanding balances and initiating collection efforts when necessary
• Analyze trends and make recommendations to the client
• Stay current with healthcare billing regulations, coding updates, and industry trends

Medical Billing Manager

General

• Manage incoming calls from patient, healthcare customers and service providers
• Deliver accurate information and support regarding healthcare policies and procedures.
• Address patient concerns, resolve issues, and follow up to ensure a satisfactory outcome.
• Maintain thorough documentation of customer interactions and transactions.
• Adhere to HIPAA and other relevant healthcare regulations.
• Coordinate with other departments to escalate and resolve complex matters efficiently.

Medical Inbound Specialist

• Submitting medical claims to the proper clearinghouse for the insurance payers to review and make the proper decision and payments
• Processing & monitoring of all claim reports & electronic documents. (Electronic and Paper Claim Transactions)
• Logging in and tracking all submission and rejection information
• Responsible for obtaining edit reports and repair claims for re submission, test, and ensure repairs are made in a timely manner
• Make sure that the claim was sent to the proper clearinghouse
• Backup the EDI claim submission and logging of information
• Keeps an update of Policy, Regulations and Payer/Clearinghouse changes
• Coordinating & testing all Electronic Data Interchange (EDI) implementations with new EDI partners & current clearinghouse
• Coordinate and work with clearing houses or trading partners to resolve EDI issues such as rejection and submission errors
• Collaborate with payers, clearinghouses and/or trading partners to successfully maintain the EDI processes
• Test, implement and document all processes required by the new accounts or new billing software
• Reviews, analyzes and coordinates implementation for service modifications by EDI ( new payer ID, claim edits)
• Monitors daily EDI performance, analyzes complex datasets, and troubleshoots issues and resolve them in a timely manner
• Facilitates the successful on-boarding of new Clients EDI accounts
• Assure interfaces (ECPP, QRSP, and HPNA) are performing as designed
• Assure data integrity (correct files/batches are uploaded)
• Manage the resolution process as needed (Coordination with Team, Leaders, account Manager)
• Escalate EDI issues to Manager/ Credentialing if unable to resolve in a timely manner
• Manage Send/Receive Files, Work Rejected claim (daily)
• Random Claim Status inquiry
• Claim File Reconciliation (batch received by charges and batch submitted by EDI)
• Analyze Rejection and detection of error patterns that need correction on the billing end

EDI Specialist, Healthcare

• Track and manage accounts receivable, ensuring aging amounts remain within targeted levels.
• Regularly check the status of submitted claims to ensure timely processing and payment.
• Resubmit claims for appeal as necessary, working to resolve any issues that may delay payment.
• Prepare and send out patient statements in a timely and accurate manner.
• Conduct patient collection phone calls, professionally addressing outstanding balances and negotiating payment arrangements.
• Respond to patient and payer's email and phone inquiries regarding their accounts, providing clear and helpful information.
• Accept phone payments from patients, ensuring accurate processing and record-keeping.
• Monitor Denial Trends and provide timely and accurate resolutions.
• Handle complex denials and appeals.
• Utilize different collection strategies to achieve optimum reimbursement on delinquent accounts.
• Follow team and/or clients proper procedures, policies, and methodologies as instructed.
• Performs other related duties as necessary or assigned.

Medical Billing Collections Specialist

• Ensure the preparation of accurate and compliant medical insurance claims for timely submission
• Oversee the submission of claims to insurance companies, ensuring adherence to deadlines
• Address claim denials by coordinating resubmissions and crafting detailed appeal letters
• Develop and implement proactive strategies to minimize claim denials
• Stay updated on the latest billing requirements, guidelines, and regulations
• Adapt billing practices to ensure compliance with industry standards
• Follow all client and team policies, procedures, and guidelines

Medical Billing Specialist

• Learn new systems of clients and effectively transfer knowledge to subordinates.
• Lead designated team, ensuring accurate and timely submission of deliverables.
• Coach subordinates and develop their skills.
• Assist Supervisor/Assistant Manager/Manager in directing the team towards the company's goals.
• Ensures compliance with company guidelines and procedures.
• Addressing any conflicts within the team that may arise.
• Create accurate medical insurance claims and ensure timely submission.
• Rectify claim denials with resubmission or appeals.
• Formulate and execute strategies to mitigate claim denials.
• Learn and implement specialty, state, carrier specific billing requirements.