Billing Specialist

Valenzuela, Metro Manila, Philippines
Full Time
Mid Level
SUMMARY
Are you a detail-oriented and customer-focused individual with a background in healthcare billing and revenue cycle management? We are seeking a highly motivated Billing Specialist to join our team. In this role, your primary responsibilities will include: processing post payments, update account statements, generate financial reports, release invoices and resolve account discrepancies. Your expertise will be essential in investigating and resolving billing errors, handling retroactive claims, and addressing coverage-related issues. Additionally, your excellent customer service skills will be pivotal in ensuring positive interactions with healthcare facilities, clients, residents, and their families. If you are results-oriented with a keen eye for detail and accuracy, we invite you to apply and contribute to our commitment to delivering high-quality service in the healthcare industry.

ESSENTIAL FUNCTIONS:
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Predictable, reliable, and punctual attendance is an essential function of the job role.
    • Work closely with facility administrators to gather necessary documentation.
    • Investigate and resolve billing errors in a timely manner.
    • Document and report errors to management for process improvement.
    • Handle retroactive billing claims for services rendered in the past.
    • Ensure compliance with regulatory requirements for retro claims submission.
    • Communicate with relevant parties to obtain missing information.
    • Update patient records promptly to prevent billing delays.
    • Manage the billing process for discharged patients.
    • Verify and close out accounts for patients who have completed their services.
    • Collaborate with internal teams to correct any inconsistencies.
    • Address inquiries and concerns related to billing processes.
    • Collaborate with the customer service team to ensure a positive experience for all stakeholders.
    • Work with insurance providers to verify and update coverage information.
    • Communicate effectively with patients and their families to explain coverage issues and facilitate resolution.
    • Ensure established billing targets are met.
    • Collect co-payments and outstanding balances from clients.
    • Prepare, verify, and process invoices and coding payment documents for assigned clients.
    • Submit invoices for payment based on individual client needs.
    • Prepare batches of invoices at client request.

PHYSICAL DEMANDS: 
The physical demands and work environment described here are representative of those an employee encounters while performing the essential functions of this job.
Sitting for extended periods of time, computer usage including data entry for much of the workday, regular phone communication, handling paperwork and documentation, and participating in meetings.

MINIMUM REQUIREMENTS: 
Education & Experience: College graduate / undergraduate, BS Pharmacy degree is preferred, or an equivalent mix of education and experience. Previous experience in healthcare billing and revenue cycle management preferred. 
Computer Skills: Intermediate computer proficiency. Knowledge of medical billing software and industry regulations required. Pharmacy and medication distribution software (EMAR, Pyxis Medbank, Frameworks preferred.
Language Skills: Ability to read and interpret documents such as medication documentation, business correspondence and procedure manuals; ability to write routine reports and business correspondence; ability to speak effectively, both in person and by telephone, to customers or employees of the organization.
Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals; ability to compute rate, ratio, and percent and to draw and interpret bar graphs; ability to understand and interpret statistical reports, data charts and graphs.

This job description is intended to convey information essential to understanding the scope of the position and it is not intended to be an exhaustive list of skills, efforts, duties, responsibilities, or working conditions associated with the role.

 

 
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