- Evaluate denied insurance claims to identify the reason for denial, such as coding errors, eligibility issues, or incomplete documentation
- Conduct thorough research and investigation to gather relevant information, documentation, and supporting evidence to address denial reason
- Update claim information, such as diagnosis code, and CPT code, or add an appropriate modifier, and rebill claims
- Write and submit appeals for certain denial reasons with appropriate documentation to support medical necessity
- Stay updated on changes in billing regulations and ensure compliance with state and federal guidelines
- Maintain confidentiality of patient information and adhere to HIPAA regulations
- Other duties as assigned.
- High school diploma or equivalent
- Minimum of 2 years of experience as a Medical Biller in a hospital or healthcare setting
- Proficient in using medical billing software and electronic health records (EHR)
- Knowledge of ICD-10, CPT, and HCPCS coding systems
- Strong understanding of insurance plans, including Medicare, Medicaid, and private insurance
- Excellent attention to detail and accuracy in data entry and documentation
- Exceptional organizational and time management skills
- Ability to work independently and collaborate with a team in a fast-paced environment
- Contributions to PhilHealth, SSS, and Pag-IBIG
- Paid leave: Sick, Paternity, Annual, Public holidays
- Monetary compensation: 13th-month pay and overtime
- If you meet the above qualifications and are interested in joining our team, please submit your resume for consideration. We look forward to hearing from you
Insurance Denials Management - Quezon City, Pilipinas - RMLPH
Paglalarawan
Denial Management/AR Follow-up
RML-PH - [Quezon City]
About Us
RML-PH is a dynamic and innovative Health Solutions and Care Delivery Organization committed to transforming the healthcare landscape. With a mission to provide accessible, high-quality healthcare services and cutting-edge solutions, RML-PH focuses on holistic patient care and embraces the latest advancements in health technology. Our team is dedicated to providing top-tier customer care, leveraging expertise and technology to exceed expectations. Join us at RML-PH to be part of a dynamic team committed to delivering excellence in healthcare customer service.
Position
We are seeking a skilled and detail-oriented individual to join our team as a Denial Management/AR Follow-up. In this role, you will play a crucial part in ensuring accurate and timely reimbursement for our hospital and healthcare services. As a Denial Management/AR Follow-up, you will be responsible for analyzing and resolving claim denials, identifying trends, and implementing strategies to prevent future denials. You will also work closely with insurance companies, patients, and internal departments to follow up on outstanding claims, resolve billing discrepancies, and provide excellent customer service.
****Apologies from RMLPH, you may have seen multiple job postings for this role. We are on a learning curve with LinkedIn, and appreciate your interest and patience with us. Please reapply to the job posting, and we hope this is the last time you will need to do this.********
Responsibilities:
Qualifications:
How to Apply: Interested candidates are encouraged to submit resumes and a cover letter outlining their qualifications and how they would contribute to RML-PH's success via LinkedIn.
Ideal start date: Whenever we find the right fit.
Schedule: Monday to Friday, 10:00 pm to 7 am
Work Location: Quezon City
Job Type: Full-time
Salary: Php 35,000-45,000 per month
Benefits:
Ability to commute/relocate: Manila, PH: Reliably commute or plan to relocate before starting work (Required)
At RML-PH, we believe in caring for our team members and their well-being. RMLPH is an equal opportunity employer. We value diversity and are committed to creating an inclusive and welcoming workplace for all employees. We encourage applications from candidates of all backgrounds and experiences.
Disclaimer: Specific positions and departments require a background check, including but not limited to, management, Toxicology, any client or patient-facing roles, and any position using a company vehicle. Continued employment is dependent on the outcome of the background check.
At RMLPH, while we appreciate the interest of staffing agencies, we do not currently partner with them. Therefore, we kindly request that resumes not be submitted unsolicited from these agencies. RMLPH assumes no responsibility for any fees incurred by agencies for unsolicited submissions of resumes.
Please only view our LinkedIn page for up-to-date job listings.
Other job sites often repost our listings but do not remove them once they are closed.