Medical Insurance Admin Assistant | WFH | Night Shift - MicroSourcing Philippines - ref. t68209423

This a Full Remote job, the offer is available from: Philippines

Discover your 100% YOU with MicroSourcing!

Work Set-up & Shift: Work From Home & Night Shift

Position Summary

An Insurance Admin Assistant is responsible for processing insurance audit requests and appeals processing, post service review of patient’s medical records and customer care team member’s transactions to ensure proper processing of orders. This role is also involved in preparing, drafting

and submitting responses to various departments or auditing agencies on matters of compliance and medical review.

• Insurance Audit Request Processing
• Handles correspondence pertaining to requests of medical documentation from all insurance, government, and commercial auditing agencies.
• Logs audit request on a spreadsheet in the shared folder
• Reviews billing history and notes of the audited equipment or accessories in HDMS (Billing Software)
• Pulls all requested medical documentation (Rx/Certificate of Medical Necessity (CMN), Chart Notes, Lab Results, Proof of Delivery, etc.) from DocFlow (Document Management Software).
• Reviews medical documentation and identify missing elements per insurance requirements
• Requests and follow up additional documentation or missing elements from doctor’s offices, hospitals, SuperCare’s customer care, medical necessity, and/or accounts receivable teams.
• Communicates to auditing agencies if clarification or additional information is required.
• Creates cover letter with summary of patient’s qualifying medical condition
• Compiles all medical documentation into one PDF file format
• Submits medical documentation to auditing agencies via fax or insurance portals.
• Insurance Appeals Processing
• Handles all correspondence pertaining to audit decisions from insurance, government, and commercial auditing agencies
• Requests and follow up additional documentation or missing elements identified during audit from doctor’s offices, hospitals, SuperCare’s customer care, medical necessity and/or accounts receivable teams
• Creates cover letter & compiles all medical documentation for all levels of appeal into one PDF file format
• Communicates decision to accounts receivable team on whether to continue to bill or pick up the equipment.

• Bachelor's Degree in Nursing, Medical Science or any other medical/healthcare field.
• At least 1-2 years of experience/background knowledge in handling insurances, appeals processing and reviewing/auditing medical records.
• Preferably with general knowledge of medical terminologies and Medicare or commercial insurance general billing guidelines.
• Ability to review/understand patient medical records and determine morbidities, limitations and needs.
• Excellent Communication Skills (both written and verbal)
• Strong organizational skills with high level of accuracy and attention to detail.
• Proficient in using MS Office (Word, Excel etc.), PDF Editors and Google Suite.
• Amenable to work on Night Shift.
• Amenable to Work From Home until further notice.

This offer from "MicroSourcing" has been enriched by Jobgether.com and got a 72% flex score.