Billing Disputes Specialist

Note: This role is for Philippines-based candidates only (we do not provide visa sponsorship).

About the Role:

The Disputes Team plays a key role in managing disputes initiated by healthcare facilities (HCFs) for invoiced shifts, addressing discrepancies in charges based on contractual terms and internal records. A Billing Disputes Specialist will review and process these disputes, determining whether to accept or reject claims based on the accuracy of the invoices and supporting records provided by the HCFs.

Responsibilities:

• Manage and resolve invoice disputes submitted by HCFs promptly and accurately.
• Conduct a thorough review of facility contracts to ensure they align with dispute resolutions.
• Make outgoing calls to HCFs and clarify details related to submitted disputes.
• Send emails to HCFs, Account Managers (AMs), and Billing Representatives (BRs) with the investigation outcomes on their submitted disputes.
• Collaborate with other Clipboard Health departments to escalate billing discrepancies when disputes require further investigation beyond the scope of a Billing Disputes Specialist.
• Identify the root cause of non-payment.

Requirements and Skills:

• Strong analytical skills with high attention to detail, particularly in reviewing contracts, billing and invoice discrepancies, and dispute documentation.
• Excellent communication skills, both written and verbal, with the ability to effectively communicate complex information to different stakeholders.
• Proficiency in Salesforce, Zendesk, Google Workspace, and other data management tools.
• Problem-solving mindset and ability to resolve issues in a timely and efficient manner.
• Strong organizational skills and ability to manage tasks in a fast-paced environment.
• Customer-oriented approach with a focus on maintaining positive relationships with our customers while enforcing contract terms.
• 1-2 years of experience in billing, invoicing, or dispute resolution is a plus.

90-Day Review

By the end of your first 90 days, the following accomplishments are expected:

• Master the dispute-handling workflow: Achieve an excellent understanding of the dispute-handling workflow with proficiency in navigating primary tools and following proper escalation procedures.
• Resolve discrepancies efficiently: Confidently identify various types of billing discrepancies and follow the appropriate resolution processes, ensuring the root cause is understood before investigation to streamline the workflow.
• Use systems and tools well: Become proficiency in using primary tools such as Salesforce, the CBH App, and Zendesk, effectively utilizing them throughout the dispute resolution process.
• Document consistently with a high attention to detail: Be consistent and thorough in documenting post-resolution notes in Salesforce cases and maintaining the weekly dashboard, minimizing unnecessary follow-ups with our customers.
• Organize effectively and manage tasks: Keep your tasks well-organized, ensure timely follow-ups, and adhere to email cadences, all of which contribute to more efficient dispute resolutions.
• Collaborate openly and actively with the Disputes Team: Collaborate with the team by sharing insights, assisting others, and helping solve problems outside of your scope. Embrace challenges as learning opportunities and maintain a proactive approach to workflow changes, contributing to the team’s success.
• Meet team targets and metrics: Meet or exceed team targets and metrics, align personal goals with daily and weekly deliverables, and proactively manage additional cases when necessary.

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