JOB DESCRIPTION:

Abbott Rapid Diagnostics is part of Abbott’s Diagnostics family of businesses, bringing together exceptional teams of experts and industry leading technologies to support diagnostic testing which provides important information for treatment and management of diseases and other conditions.

The position of Claims Inspector is within the Acelis Connected Health Department/Heart Failure located in the Philippines. This role handles and resolves all insurance follow up and denial issues to ensure that company receives correct reimbursements from the insurance companies. The incumbent will serve as the liaison between insurance companies, patients and the departments to ensure the claims are processed and followed up to meet company’s goals of Account Receivable Days, Aging Account percentages and Cash goals. They will also research and answer all questions and complaints, regarding patient responsibility balances and billing inquiries sent to them through the customer call center with the highest degree of courtesy and professionalism.

RESPONSIBILITIES:

• Demonstrates proficiency and accuracy in operating systems directly related to specific job function.

• Prepares medical record packets and uploads to the document repository tool for newly billed claims.

• Submits medical record packets via facsimile transmission to the payer for newly billed claims or in response to additional information request. (Medicare)

• Initiates contact with insurance carriers regarding status on claims. (Commercial)

• Assigns denied or paid claims to Level II for further action or follow-up with the payer.

• Escalates claims to be reviewed by the Billing Team for accuracy and validity of charges.

• Maintains accurate and detailed notes/documentation in applicable systems.

• Keeps Supervisor and/or Manager informed of system issues.

• Observes legal and ethical guidelines for safeguarding patient and company confidentiality (HIPAA).

• Other duties as assigned.

BASIC QUALIFICATIONS | EDUCATION:

• Completed at least 2 years in College or with an Associate or Bachelor’s Degree

• Excellent oral and written communication skills

• Thorough understanding of the US Healthcare Insurance claims

PREFERRED QUALIFICATIONS:

• Proficient Medicare and solid general payer knowledge

• Has the ability to read and interpret explanation of benefits

• Basic Excel, Word and Outlook experience required

• Typing using computer keyboards, 10-key pads and calculators

• Strong Computer/Software Skills

• Detail-oriented

• Typing speed of 35 wpm

• Occasional weekend work may be required

• Must be flexible to work on a night shift (between 6pm to 10am) Philippine Standard Time.

• Must be amenable to work on Overtime or during Rest Days when business requests for additional (paid) hours

COMPETENCIES:

• Internal – At least 1 year tenure in ACH

• External – 1 year of experience in Healthcare Insurance Collections and/or Correspondence

     

The base pay for this position is

N/A

In specific locations, the pay range may vary from the range posted.

     

JOB FAMILY:

Accounts Payable & Receivables, Credit & Collection, & Payroll

     

DIVISION:

HF Heart Failure

        

LOCATION:

Philippines > Taguig City : Five/Neo Building

     

ADDITIONAL LOCATIONS:

     

WORK SHIFT:

Standard

     

TRAVEL:

Not specified

     

MEDICAL SURVEILLANCE:

Not Applicable

     

SIGNIFICANT WORK ACTIVITIES:

Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day)