Claims Processor (Must have ABA experience) | Work from home

Philippines
Permanent
Full-time

1 month ago

We are a leading healthcare technology company specializing in software solutions for disability and aged care providers. Their platform streamlines operations, enhances compliance, and improves service delivery for organizations managing complex care needs. With a strong focus on NDIS compliance, care management, and workflow automation, we empower providers to deliver high-quality, person-centered care efficiently.What You’ll Do:

Process and submit claims for ABA providers, ensuring accuracy and compliance.
Monitor claim statuses and remittances, proactively following up on outstanding payments.
Investigate and resolve claim denials, corrections, and appeals with insurers.
Manage patient responsibility invoices, including co-pays and co-insurance.
Review and analyze Explanation of Benefits (EOBs) and post manual payments as needed.

Essential Experience:

Minimum of 3 years in medical billing, specifically for commercial and Medicaid insurance plans.
Hands-on experience with electronic medical records (EMR) and practice management systems.
Proficiency in working with clearinghouses and payer portals.
Strong understanding of the denials management and appeals process.

Preferred Qualifications:

Advanced Excel skills for data tracking and analysis.
Experience in data analysis and reporting.
Knowledge of SQL for querying and managing healthcare data.
Background in ABA (Applied Behavioral Analysis) billing is a must.

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