#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 Ambulatory/Outpatient Services to join our team. The ideal candidate will be responsible for managing the complete accounts receivable cycle, ensuring timely claim submissions, resolving payment discrepancies, and improving revenue cycle efficiency.

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.

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: TBD (US work hours)

Work-type: Full-time Steady state

Requirements

• Minimum 3 years of experience in AR management, with at least 2 years in healthcare/Ambulatory/Emergency services.

• Strong knowledge of Ambulatory/Emergency services billing codes, procedures, and insurance payer policies.
• Proficiency in using billing software, AR systems, and Electronic Health Records (EHR) such as HST Pathways, Vision, Advantix, SIS Complete.
• 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

Benefits

• Permanent Work From Home
• Weekly Paychecks
• Fixed Weekends Off
• Great Company Culture and No Micromanagement
• Thriving Company Culture with Complete Autonomy
• Unlock Your Potential with a Highly Competitive Salary

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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.