About this role
ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Medical Billing Specialist to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!
Account specific roles & responsibilities:
- Manage the end-to-end medical billing process, including claim preparation, submission, tracking, and follow-up.
- Review patient information, billing records, and supporting documentation to ensure claims are accurate and complete.
- Submit medical claims to HMOs, insurance providers, and other relevant payers in accordance with established guidelines.
- Monitor claim statuses and conduct timely follow-ups on pending, delayed, rejected, or denied claims.
- Investigate claim denials, identify root causes, and coordinate necessary corrections, resubmissions, or appeals.
- Perform cash posting and accurately record payments, adjustments, and other billing transactions.
- Reconcile payments against submitted claims and investigate discrepancies or underpayments.
- Maintain accurate and organized billing records and documentation.
- Coordinate with internal teams and relevant stakeholders to resolve billing issues and support timely reimbursement.
- Ensure compliance with applicable billing requirements, payer guidelines, and internal procedures.
- Monitor outstanding claims and accounts receivable to help minimize payment delays and maintain an efficient revenue cycle.
Requirements
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At least 6 months BPO experience handling US Healthcare account
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Good Working knowledge with HMO Billing (Claims, Denials, Cash Postings)
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Knowledge on Revenue Cycle Management/ Accounts Receivable is a PLUS
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Excellent written and verbal English communication skills
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Amenable to work onsite in Buendia, Makati or Shaw Blvd, Mandaluyong
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Willing to work night shifts
Benefits
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What can we offer you?
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Competitive salary and benefits
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Health Insurance with free dependents*
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10%-night differential
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Attendance Bonus
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Paid time off
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Convertible to cash leave credits
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Performance Appraisal
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Work-life balance
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A focus on growing your career path with us
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We encourage you to follow your passions and learn new skills
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Our commitment to you
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Strong culture and values-driven leadership
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We create opportunities for you to learn and grow at any stage of your career
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Continuous learning and innovation
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We foster an all inclusive environment where everyone thrives