Customer Service Representative for US Healthcare Insurance (McKinley Taguig)

RESPONSIBILITIES:

Performs AR follow-up on assigned accounts taking into account Timely Filing Limits set by the payer.Submits adjustments or write-off requests for approval to resolve outstanding account balances.Submits medical record packets for submission to the payer for claims reprocessing, reconsideration or appeal requests. Receives inbound calls/ call backs from payers/insurances regarding accounts that they are actively working on.Resolves claim rejections accordingly in order to release a clean claim to the payer. Responds to e-mail inquiries from different departments regarding pending insurance balances or claim denials. Maintains accurate and detailed notes/documentation in applicable systems.Keeps Supervisor and/or Manager informed of system issues.Observes legal and ethical guidelines for safeguarding patient and company confidentiality (HIPAA)Other duties as assigned.

 BASIC QUALIFICATIONS | EDUCATION:

Completed at least 2 years in College or with an Associate or Bachelor’s DegreeExcellent oral and written communication skillsThorough understanding of the US Healthcare Insurance claims

PREFERRED QUALIFICATIONS:

Proficient Medicare and solid general payer knowledgeHas the ability to read and interpret explanation of benefitsBasic Excel, Word and Outlook experience requiredTyping using computer keyboards, 10-key pads and calculatorsStrong Computer/Software SkillsDetail-orientedTyping speed of 35 wpmOccasional weekend work may be requiredMust be flexible to work on a night shift (between 6pm to 10am) Philippine Standard Time.Must be amenable to work on Overtime or during Rest Days when business requests for additional (paid) hours

COMPETENCIES:

Internal – At least 1 year tenure in ACHExternal – 1 year of experience in Healthcare Insurance Collections and/or Correspondence

BusinessTrends Philippines is a leading provider of total workforce management solutions that has been operating in the Philippines since 1999.  BusinessTrends is a part of the SFI Group of Companies, which has been in the Workforce Management industry since 1961.BusinessTrends  offers a comprehensive array of managed workforce solutions, permanent placement, outsourcing, specialized recruitment and consulting services. BusinessTrends’ workforce management expertise is being utilized by numerous companies in various industries: Business Process Outsourcing, Information Technology, Banking and Finance, Engineering, Real Estate and Property Management, Scientific & Healthcare, and Professional Support.BusinessTrends complies with the Department Order 18-A under Department of Labor and Employment and a proud member of People Management Association of the Philippines, American Chamber of Commerce and the IT and Business Processing Association of the Philippines.