[ref. n44151220] Monroe Consulting Group Philippines - Medical Billing & Insurance Claims Specialist New

Key Responsibilities:

Outbound Calling:

• Make outbound calls to insurance companies and payors to collect essential information, including claim statuses, denial reasons, and any additional relevant details.
• Conduct all calls in full compliance with the Client's guidelines and applicable healthcare regulations.
• Maintain professionalism and ensure clear communication during each call.

Data Categorization and Labeling:

• Accurately record, categorize, and label calls or information gathered using the taxonomy and definitions provided by the client.
• Ensure all claim statuses and call outcomes are properly labeled for consistency in reporting and easy analysis.
• Deliver categorized data in periodic reports or through the portal developed by client, following the requested format and frequency.

Call Transcript Analysis:

• Analyze recorded call transcripts to extract actionable insights, identifying trends, recurring denial reasons, and other patterns.
• Compile findings into periodic reports, providing valuable information to the Client to support process improvements and optimize workflows.

Qualifications:

• Minimum of 1 year of experience in medical billing, insurance claims, or a related field.
• Strong English proficiency, both verbal and written.
• Familiarity with healthcare regulations and industry guidelines.
• Excellent communication skills with the ability to make outbound calls to insurance companies and payors.
• Detail-oriented and able to maintain accurate records.
• Ability to work independently while adhering to internal guidelines and procedures.
• Proficiency in Microsoft Office Suite or similar software; experience with medical billing software is a plus.