AR Team Lead (Healthcare Account)
Pasig City, National Capital Region
Posted 9 days ago
- Company:
- Visaya Knowledge Process Outsourcing Corp
- Company Description:
- Visaya Knowledge Process Outsourcing Corporation started out in 2007 with a handful of employees who dedicated themselves to exemplary and cost-efficient service delivery. As a proudly Filipino organization, we draw deeply from a culture of ‘malasakit’, or caring. Client engagement isn’t just a one-off interaction – it’s an opportunity to build a lasting relationship. Following this, we offer a unique brand to your customers, clients, stakeholders and employees by running processes at the highest standards of quality and security, while always showing them the courtesy and consideration for which Filipinos are known.
- Contract Type:
- Full Time
- Experience Required:
- 2 years
- Education Level:
- Bachelor’s Degree
- Gender:
- Female
- Number of vacancies:
- 2
Job Description
Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers
Update patient demographics/insurance information in appropriate systems Research/ Status unpaid or denied claims
Monitor claims for missing information, authorization, and control numbers (ICN//DCN)
Research EOBs for payments or adjustments to resolve claim
Contacts payers via phone or written correspondence to secure payment of claims Access client systems for payment, patient, claim and data info
Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems
Secure needed medical documentation required or requested by third party insurance carriers.
Maintain confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure
Perform other related duties as required
Utilize provider billing manuals to obtain billing guidelines and requirements.
Write appeal letters for technical appeals
Verifies accuracy of underpayments utilizing contracts and claims data.
Prepares claims for clinical audit processing in the case of authorization, coding, level of care and/or length of stay denials
Utilizes reports for analysis and to monitor follow up activities and prioritization
Assists organization with working through special projects as needed
SME for colleagues and provide direction for resolution of accounts
Assists in new hire training
Assists in content building of training materials
Qualifications & Competencies
3+ years of medical collections/billing experience
2+ years of experience as a Team Leader
Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI
Expert knowledge of third-party billing guidelines
Expert knowledge of billing claim forms (UB04/1500)
Expert knowledge of payor contracts
Working Knowledge of Microsoft Word and Excel
Intermediate working knowledge of health information systems (i.e., EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
Must be willing to work onsite.