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Insurance Accounts Receivable Specialist

Remote · Philippines Full-time

Job Description:

  • Perform billing-related tasks as assigned, including data entry, claim review, charge review, and accounts receivable follow-up
  • Focus on resolving entry-level insurance denials, such as those related to medical records, eligibility, and coordination of benefits (COB)
  • Complete daily tasks within assigned work queues based on manager direction and established workflows
  • Utilize CBO Pathways, payer websites, billing systems, and training materials to determine appropriate actions for resolving unpaid or underpaid claims and authorizing procedures
  • Identify potential issues related to payer requirements, provider credentialing, or coding, and escalate to management as appropriate
  • Review reports to identify unpaid claims and potential revenue opportunities
  • Communicate effectively with providers, patients, coders, and other stakeholders to ensure accurate and timely claims processing
  • Adhere to departmental workflows, operational policies, compliance guidelines, and regulatory requirements, including FGP and patient confidentiality standards
  • Provide input on system edits, process improvements, policies, and billing procedures to support revenue cycle optimization
  • Participate in meetings and workgroups, complete all required training sessions, and actively seek additional training when needed
  • Read and apply policies and procedures to make informed decisions, coordinate functions with team members, and explain processes clearly to others
  • Make system corrections and resubmit claims as necessary to meet payer requirements
  • Performs other position related duties as assigned

Requirements:

  • High school diploma or equivalent required
  • Previous experience in a customer service or healthcare setting preferred
  • Excellent interpersonal and communication skills
  • Strong customer service orientation and a friendly, approachable demeanor
  • Basic knowledge of medical facility layout and department functions (training provided)
  • Dependability and punctuality
  • Ability to work independently and as part of a team
  • Cultural sensitivity and ability to interact respectfully with diverse populations
  • Skill in using computer programs and applications including Microsoft Office

Benefits:

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life Insurance
  • Pet Insurance
  • Health savings account
  • Paid sick time
  • Paid time off
  • Paid holidays
  • Profit sharing
  • Retirement plan

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