Deskripsi Pekerjaan
Are you an experienced Revenue Cycle Management (RCM) professional looking to advance your career with a global healthcare leader? Optum is seeking a highly skilled US Healthcare Collections Specialist to join our high-performing team in Metro Manila. In this role, you will be the backbone of our financial operations, ensuring the seamless reconciliation of claims and the optimization of provider-side revenue.
You will be tasked with navigating complex insurance contracts, identifying root causes for unpaid claims, and executing strategic follow-ups to resolve denials. If you have a keen eye for detail, a strong background in US medical billing, and a commitment to operational excellence, we want to hear from you. Join Optum and contribute to our mission of helping people live healthier lives and making the health system work better for everyone.
Tanggung Jawab
- Manage the end-to-end medical billing cycle, focusing on high-volume AR follow-ups.
- Analyze and interpret insurance contracts to ensure accurate reimbursement levels.
- Identify, document, and resolve claim denials by collaborating with insurance carriers and internal stakeholders.
- Perform comprehensive billing reconciliation to ensure financial data integrity.
- Conduct regular outbound calls to insurance providers to check claim status and accelerate payment timelines.
- Maintain precise records of all collection activities and account adjustments within the billing system.
- Meet or exceed daily production and quality metrics for AR aging buckets.
Kualifikasi
- At least 1-2 years of experience in US Healthcare Revenue Cycle Management (AR/Collections).
- Deep understanding of the end-to-end claim adjudication process.
- Proficiency in identifying and resolving common denial codes and rejection trends.
- Excellent verbal and written communication skills for professional interactions with US insurance payers.
- High level of analytical proficiency with medical billing software and MS Excel.
- Strong problem-solving skills and the ability to work independently in a fast-paced environment.
- A proactive approach to identifying process improvements to reduce DSO (Days Sales Outstanding).