Healthcare AR Specialist (US Accounts)

Work set-up: Onsite

Shift: Night Shift / US Shifts

Location: ALABANG, MUNTINLUPA

Job Requirements:

• Graduate of any college degree.
• Must have 2+ years in a Healthcare BPO setting
• Knowledge of commercial, HMO, Medicare/Medicaid, and other payer requirements.
• Working knowledge on the use of insurance payer websites ie: Availity, Optum, Medicare, Evicore portals.
• Working knowledge with Practice Management systems, preferably KAREO a plus.
• Effective communication abilities
• Proven problem-solving skills
• Proficient knowledge of medical terminology is likely to be encountered in medical claims denials.
• Amenable to work onsite during training and nesting period in Alabang, Muntinlupa City and US shifts

Responsibilities:

• Perform accounts receivable follow-ups for US healthcare accounts, including voice communication with payers.
• Review and resolve medical claims denials in compliance with commercial, HMO, Medicare/Medicaid, and other payer requirements.
• Utilize insurance payer portals (e.g., Availity, Optum, Medicare, Evicore) and Practice Management systems (KAREO preferred).
• Communicate effectively with internal teams and external payers to ensure timely claim resolution.
• Apply knowledge of medical terminology to analyze and address claim issues.
• Participate onsite during training and nesting periods; work US shifts as required.