Job description
#1 PH Workforce Delivering to the US
MedCore Solutions, the healthcare division of Bizforce, is looking for an experienced Accounts Receivable (AR) Specialist with expertise in Hospital Billing experience to join our team. The ideal candidate will be responsible for handling the full spectrum of billing and accounts receivable processes, with a strong focus on hospital medical bill audits. Proficiency in Epic Systems is required. This role plays a critical part in ensuring accurate and timely reimbursement for healthcare services rendered.
Key Responsibilities:
Billing and Claims Management:
- Prepare, review, and submit claims for procedures.
- Monitor and ensure accuracy in claim submissions and compliance with payer requirements.
- Review and audit hospital medical bills to ensure accuracy and compliance with payer requirements.
Accounts Receivable Tracking:
- Track and manage outstanding accounts receivable to ensure timely payments.
- Follow up with insurance companies and patients to resolve unpaid claims and balances.
Denial Management:
- Identify, research, and resolve claim denials or underpayments related to Ambulatory/Emergency services.
- Coordinate with coding and billing teams to rectify issues and resubmit claims.
Reconciliations:
- Reconcile payments, adjustments, and account balances to maintain accurate financial records.
- Ensure all accounts are accurately updated in the system.
Reporting:
- Generate AR aging reports and provide insights into trends and challenges in payment cycles.
- Contribute to monthly financial reporting for leadership review.
Compliance:
- Stay updated on payer policies, coding guidelines, and Ambulatory/Emergency billing regulations.
- Ensure compliance with HIPAA and organizational policies.
Other details:
Start Date: TBD
Schedule: 8 hours/day Monday-Friday; 40 hours/week
Days Off: Saturday & Sunday
Time zone: Eastern Standard Time
Work-type: Full-time Steady state
- Minimum 3 years of experience in AR management, with at least 2 years in Hospital billing.
- Extensive experience in hospital medical bill audits.
- Proficient in Epic Systems for billing, claims, and AR workflows.
- Excellent analytical and problem-solving skills.
- Exceptional attention to detail and organizational abilities.
- Effective communication and negotiation skills for resolving payment issues.
- Willing to work in a graveyard shift (US time zone)
Key Results
- Reduce coding and billing error rate
- Achieve the target collections goals set and collections status report
- Reduced number of denials and complaints
- Achieve an accuracy rate of 99%
- Utilization of billing and coding software programs
System Requirements
Candidates must have the following on their device (Desktop or Laptop):
Processor: Either Intel Core i5 and up or AMD Ryzen 5 and Up
RAM: 8GB and up
OS: Windows 11 Pro (Windows 10 Pro is acceptable but not preferred). OS should be a legit license
Internet Connectivity: At least 50 Mbps and should be wired
Back-up connection and Power Supply
Hard Disk: At least an SSD
For Mac: Processor - Apple M1 chip
RAM: 8GB and up
Permanent Work From Home
Weekly Paychecks
Fixed Weekends Off
Great Company Culture and No Micromanagement
Thriving Company Culture with Complete Autonomy
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Who We Are
MedCore Solutions is one of the fastest-growing global outsourcing companies in the world, founded in the US in Tucson, Arizona and is now operational in PH!
Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.
Why work with us?
MedCore Solutions (MCS) is a single source solution for Healthcare administration. MCS is an industry leader for medical billing, credentialing, scribing, insurance verification, compliance and virtual staffing. Upon your request our team of certified coders, can perform a detailed billing analysis to determine if you are receiving the maximum amount of revenue while conforming to CMS guidelines. Ask how MCS can streamline your hospital or practice making healthcare administration simple, effective, and affordable. We pride ourselves on giving you the best solutions tailored to your practice’s specific needs, so you can focus on your patients and revenue producing activities.
