Sr. Associate - Claims

Responsible for the accurate processing and completion of issues or tickets raised by member medical claims based on defined claims guidelines and policies. Associate can demonstrate proficiency in product lines applicable to the processing unit.

• Send invoices and account updates.
• Keep an accurate record of member accounts and outstanding balances.
• Receive, sort, and track incoming payments.
• Validate debit accounts to ensure the credibility of payments.
• Issue receipts for received payments.
• Address and solve member questions and issues.
• Securely handle client data and payment information.
• Provide regular, accurate reports of billing data.

Education

• Bachelor’s Degree holder is an advantage.
• Credential/Professional Certification related to current work is an advantage.

Work Experience

• At least 2 years BPO US Healthcare experience required.
• Billing or Claims experience is preferred.
• Willing to work at night and comfortable in performing outbound calls as needed.
• Strong communication skills.
• Great team player with excellent interpersonal skills.
• Willing to work on site.
• Knowledge and working experience with ORMB tool an advantage but not required.

Other qualifications:

• Proficient knowledge on US Healthcare Practice, ICD-10, CPT4, DRG, HCPCS, Clinical Documentation Improvement, medical terminologies, EDI, and HIPAA protocols
• Ability to multi-task and follow documented claims processes with minimal supervision.
• Excellent verbal and written business communication skills required.
• Strong proficiency in Windows OS and Microsoft Office applications, particularly Excel.
• Strong attention to detail and the ability to make appropriate decisions based on information available.