Total 8 quality assurance specialist job vacancies in quezon city metro manila

MedCore Solutions, Bizforce's medical division is currently seeking a Dental Insurance Verifier to join our team. As a Dental Insurance Verifier, you will play a critical role in the dental insurance process by verifying insurance coverage and benefits for patients. You will be responsible for working closely with dental providers, insurance companies, and patients to ensure accurate and timely verification of insurance information.

At MedCore Solutions we prioritize efficiency, accuracy, and excellent customer service. We are looking for a detail-oriented and organized individual who is experienced in dental insurance verification and has a strong understanding of dental terminology and procedures.

Who We Are

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.

We offer an expansive suite of administrative products and trainings to keep your practice and its employees safe and up to date with compliance and to avoid fines and litigation. Our online compliance center is quick and easy to use, and provides you with an extensive library of training courses, covering OSHA, HIPAA, Human Resources, Health Plan Management, Patient Safety and Regulations, Infection Control, and much more.

Responsibilities:

• Assist and handle incoming calls from members and/or providers
• Verify dental insurance coverage and benefits for patients (and a little of dental claims)
• Communicate with dental providers, insurance companies, and patients to gather necessary information
• Ensure accuracy and completeness of insurance verification
• Enter and update insurance information in the system
• Resolve any discrepancies or issues related to insurance coverage
• Provide excellent customer service to patients by addressing their insurance-related inquiries and concerns

• At least 3 years of experience in dental insurance verification (members and providers) in the US healthcare
• Strong understanding of dental terminology and procedures
• Knowledge of dental insurance plans and coverage
• Detail-oriented with excellent data entry skills
• Strong communication and interpersonal skills
• Ability to work independently and as part of a team
• Proficient in using dental insurance verification software/systems
• Amenable to work in a graveyard shift

Other details:

Start Date: TBD

Schedule: 8 hours shift Monday - Friday; Days off: Saturday and Sunday

Type of Work: Full-time

Location: Permanent Work from Home

Duration: Steady State

Training: At least 1-2 weeks

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.

Permanent Work From home

Permanent Weekends Off

Great Company Culture and No Micromanagement

Benefits

MedCore Solutions, Bizforce's medical division, is seeking for skilled WFH Rheumatology Medical Billers to join our team. As a US Medical AR Specialist, you will manage accounts receivables, coordinate with insurance companies and healthcare providers, handle denied claims, and ensure timely reimbursement of medical expenses. The successful candidate will work from home permanently and will have the opportunity to work with a dynamic team in a fast-paced environment. BizForce & MedCore Solutions allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world.

Who We Are

MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in 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.

Responsibilities

• Manage accounts receivables and keep up-to-date records
• Coordinate with healthcare providers and insurance companies for claim submission and follow-up
• Generate revenue by making payment arrangements, collecting accounts, and monitoring and pursuing delinquent accounts
• Collect delinquent accounts by establishing payment arrangements with patients, monitoring payments, and following up with patients when payment lapses occur
• Maintain Medicare bad-debt cost report
• Secure outstanding balance payments for the care of employees
• Verify insurance eligibility for patients and ensure timely payment
• Handle denied claims and appeal if necessary
• Reconcile payments and post to patients' accounts
• Maintain compliance with HIPAA regulations
• Handle patient inquiries regarding their accounts

Other details:

Start Date: TBD

Schedule: 8 hours/day Monday-Friday; 40 hours/week

Days Off: Saturday & Sunday

Time zone: EST

Duration: Full-time Steady state

• At least 3-5 years of experience as a US Medical AR Specialist
• Knowledge of medical billing and coding practices
• Strong understanding of the healthcare billing process
• Familiarity with healthcare insurance plans and related policies
• Experience with HIPAA regulations
• Excellent communication and customer service skills
• Strong attention to detail
• Strong computer skills and experience with medical billing software.
• Amenable to work in any US time zones (graveyard shift)
• At least 1 year of experience in Physical Therapy billing
• Preferably with experience in Agile EMR

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

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5
• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up

Our Commitment to delivering high-quality results for our clients and the only way to do that is by ensuring a rewarding, respectful, and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From Home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education

• Specialized Training

#1 PH Workforce Delivering to the US

MedCore Solutions, the Medical Division of Bizforce, is seeking a skilled Prior Authorization Specialist to join our growing team. The Prior Authorization Specialist we be primarily responsible for obtaining all types of prior authorizations. These prior authorizations will include biologic medications, procedures, prescriptions and out-patient testing. The position will require professional and courteous interaction with patients, pharmaceutical representatives, providers, pharmacies and insurance carriers to accurately obtain the required information to process prior authorizations.

Responsibilities

• Review and process prior authorization requests for medical services, procedures, and medications
• Verify insurance (pharmacy) information and eligibility
• Handle patient inquiries regarding authorizations
• Provide necessary prior authorization documentation to patients for completion and signature. Review all forms for completeness and accuracy.
• Accurately document all patient, pharmacy and insurance carrier interactions in EMR.
• Coordinate with healthcare providers and insurance companies to obtain necessary authorizations
• Ensure accurate and timely documentation of authorization requests and approvals
• Collaborate with medical billing team to resolve any issues or denials
• Maintain up-to-date knowledge of insurance guidelines and procedures
• Complete other tasks as assigned by providers through EMR/EHR
• Copy, fax and mail documents and information as requested by insurance carrier
• Schedule follow-up appointments, biologic injections and photodynamic therapy treatments
• Assist pathology department with notifying patients of pathology results via telephone
• Fulfill organizational responsibilities as assigned, which may include but are not limited to: respecting and promoting patient’s rights, responding appropriately to emergency situations, sharing problems relating to patients and/or staff with Care Center Leader in a timely manner
• Provide safe patient-centered, compassionate, and competent care

Other details:

Start Date: TBD

Schedule: 8 hours/day Monday-Friday; 40 hours/week

Days Off: Saturday & Sunday

Time zone: EST

Duration: Full-time Steady state

• Proven 3-5 years of experience as a Prior Authorization Specialist in the US Healthcare

• Strong understanding of medical billing and insurance processes
• Excellent communication and interpersonal skills
• Detail-oriented with strong organizational skills
• Ability to work independently and meet deadlines
• Comfortable working in a remote, work-from-home setup
• Experience handling Physical Therapy practice/account
• Experience using Agile EMR is a bonus
• Amenable to work in a graveyard shift

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5

• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up

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.

• Permanent Work From home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education
• Specialized Training

Who We Are

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.

We offer an expansive suite of administrative products and trainings to keep your practice and its employees safe and up to date with compliance and to avoid fines and litigation. Our online compliance center is quick and easy to use, and provides you with an extensive library of training courses, covering OSHA, HIPAA, Human Resources, Health Plan Management, Patient Safety and Regulations, Infection Control, and much more.

MedCore Solutions, Bizforce's medical division, is seeking skilled WFH Rheumatology Coders to join our team. As a Rheumatology Coder, you will be responsible for reviewing and analyzing medical records, assigning appropriate codes for diagnoses and procedures, and ensuring compliance with coding guidelines and regulations. This position offers the flexibility of remote work from home permanently.

Who We Are

MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in 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. 

Responsibilities

• Review and analyze medical records to accurately assign ICD-10-CM, CPT, and HCPCS codes
• Ensure coding accuracy and compliance with coding guidelines and regulations
• Abstract clinical information from medical records and assign appropriate codes
• Collaborate with healthcare professionals to clarify documentation and obtain necessary details
• Stay updated with changes in coding guidelines and regulations
• Meet productivity and quality targets
• Translate details from a patient's medical documents into medical codes for health insurance claims purposes
•  Ensures accurate data entry of the coding and claims submission for services provided by physicians, including assigning the correct ICD and CPT codes
• Provides support to clinic/practice managers and staff in determining accurate coding and billing practices
• Liaising with the client/provider and team members for coding-related queries and concerns
• Perform audits for coding denials, missing information, and charts
• Maintain a tracking system for the charts coded and ensure work completion
• Research coding and claims questions thoroughly to maintain high-quality standards

Other Details

• The possible start date will be in 2 weeks or earlier
• 8-hour shift Monday-Friday (graveyard shift)
• Weekend days off
• Duration: Long-term; Steady-state

• Must be AAPC/AHIMA certified coder
• At least 3-5 years of clinical experience in Medical Coding (Outpatient/Inpatient)
• Knowledgeable in US Insurance Plan Structure and HIPAA regulations
• Good oral and verbal English communication skills as well as listening skills
• Capacity to navigate challenging situations with ease
• Willing to work in a graveyard shift (US time zone)
• Excellent communication and teamwork skills
• At least 1 year of experience in Rheumatology coding
• NextGen system experience - bonus

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5
• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up

Our Commitment to delivering high-quality results for our clients and the only way to do that is by ensuring a rewarding, respectful, and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From Home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education

• Specialized Training

#1 PH Workforce Delivering to the US

Bizforce and our medical billing division, MedCore Solutions, are seeking skilled Medical Coders to join our growing team. As a Medical Coder at MedCore, you will be responsible for translating details from a patient's medical documents into medical codes for health insurance claims purposes. Additionally, you will be liaising with the client and team members for coding-related queries and concerns, performing audits for coding denials and missing information, and maintaining a tracking system for coded charts. MedCore allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today!

Who We Are

MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in medical billing, credentialing, scribing, insurance verification, compliance, and virtual staffing.

We offer an expansive suite of administrative products and training to keep your practice and its employees safe and up-to-date with compliance and to avoid fines and litigation. Our online compliance center is quick and easy to use and provides you with an extensive library of training courses, covering OSHA, HIPAA, Human Resources, Health Plan Management, Patient Safety and Regulations, Infection Control, and much more.

Responsibilities

• Translate details from a patient's medical documents into medical codes for health insurance claims purposes
•  Ensures accurate data entry of the coding and claims submission for services provided by physicians, including assigning the correct ICD and CPT codes
• Provides support to clinic/practice managers and staff in determining accurate coding and billing practices
• Liaising with the client/provider and team members for coding-related queries and concerns
• Perform audits for coding denials, missing information, and charts
• Maintain a tracking system for the charts coded and ensure work completion
• Research coding and claims questions thoroughly to maintain high-quality standards

Other Details

• The possible start date will be in 2 weeks or earlier
• 8-hour shift Monday-Friday (graveyard shift)
• Weekend days off
• Duration: Long term; Steady-state

• Must be AAPC/AHIMA certified coder
• At least 3-5 years of clinical experience in Medical Coding
• At least 6 months experience in Rheumatology coding
• Knowledgeable in US Insurance Plan Structure and HIPAA regulations
• Good oral and verbal English communication skills as well as listening skills
• Capacity to navigate challenging situations with ease
• Willing to work in a graveyard shift (US time zone)
• Experience in using Athena Health EMR/EHR is a bonus

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5

• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up
• Peripherals: Headset with noise-canceling feature

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.

• Permanent Work From home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education
• Specialized Training

#1 PH Workforce Delivering to the US

MedCore Solutions, is seeking a skilled Prior Authorization Specialist with Medical Billing experience to join our growing team. We are partnering with some of the largest healthcare platforms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today! The traditional model of the office workforce has been shifting as outsourcing has grown in PH at rates never before seen. As global businesses rise out of the pandemic, labor markets have not only tightened but the inflationary rates have caused companies to look for solutions on how to best deliver skilled labor services and results. We are proud to partner with PH and deliver qualified, professional workers, giving our employees the ability to have an unbeatable career and work from home.

Who We Are

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.

Responsibilities

• Review and process prior authorization requests for medical services, procedures, and medications
• Verify insurance information and eligibility
• Coordinate with healthcare providers and insurance companies to obtain necessary authorizations
• Ensure accurate and timely documentation of authorization requests and approvals
• Collaborate with medical billing team to resolve any issues or denials
• Maintain up-to-date knowledge of insurance guidelines and procedures
• Manage accounts receivables and keep up-to-date records
• Tasks will gradually transition into a Biller/AR task
• Coordinate with healthcare providers and insurance companies for claim submission and follow-up
• Generate revenue by making payment arrangements, collecting accounts, and monitoring and pursuing delinquent accounts
• Verify insurance eligibility for patients and ensure timely payment
• Handle denied claims and appeal if necessary
• Reconcile payments and post to patients' accounts
• Maintain compliance with HIPAA regulations
• Handle patient inquiries regarding their accounts

Requirements:

• Previous experience as a Prior Authorization Specialist in a medical billing setting
• Strong understanding of medical billing and insurance processes
• Excellent communication and interpersonal skills
• Detail-oriented with strong organizational skills
• Ability to work independently and meet deadlines
• Proficient in using medical billing software and MS Office Suite
• High school diploma or equivalent, relevant certifications a plus
• Comfortable working in a remote, work-from-home setup

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.

• Permanent Work From home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education
• Specialized Training

#1 PH Workforce Delivering to the US.

MedCore Solutions, is seeking Credentialing Specialists and Medical Billers to join our growing team. BizForce & MedCore allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today! The traditional model of the office workforce has been shifting as outsourcing has grown in PH at rates never before seen. As global businesses rise out of the pandemic, labor markets have not only tightened but the inflationary rates have caused companies to look for solutions on how to best deliver skilled labor services and results. We are proud to partner with PH and deliver qualified, professional workers, giving our employees the ability to have an unbeatable career and work from home.

Who We Are

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.

Responsibilities

• Process applications for healthcare provider enrollment and privileging with insurance companies and various other organizations
• Coordinate and facilitate the credentialing and re-credentialing processes
• Submit and monitor credentialing applications to ensure timely completion
• Review and verify provider credentials and documents for accuracy and completeness
• Communicate with providers, insurance carriers, and organizations to obtain missing or additional information as necessary
• Maintain accurate and up-to-date provider information and credentialing files
• Manage accounts receivables and keep up-to-date records
• Coordinate with healthcare providers and insurance companies for claim submission and follow-up
• Generate revenue by making payment arrangements, collecting accounts, and monitoring and pursuing delinquent accounts
• Verify insurance eligibility for patients and ensure timely payment
• Handle denied claims and appeal if necessary
• Reconcile payments and post to patients' accounts
• Maintain compliance with HIPAA regulations
• Handle patient inquiries regarding their accounts

• Proven work experience as a Credentialing Specialist and/or Medical Biller
• Solid understanding of healthcare provider enrollment and privileging processes
• Experience with billing software and electronic medical records
• Knowledge of medical insurance policies and claim processes
• Must have the ability to multitask and manage time effectively
• Excellent written and verbal communication skills
• Outstanding problem-solving and organizational abilities

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.

• Permanent Work From home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education
• Specialized Training

MedCore Solution, Bizforce's medical division, is seeking a skilled WFH US Medical AR Specialist who is experienced in DME/Podiatry billing to join our team. As a US Medical AR Specialist, you will manage accounts receivables, coordinate with insurance companies and healthcare providers, handle denied claims, and ensure timely reimbursement of medical expenses. The successful candidate will work from home on a permanent basis and will have the opportunity to work with a dynamic team in a fast-paced environment. BizForce & MedCore Solutions allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world.

Who We Are

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.

Job Details
Schedule: 8hrs shift (TBA) Mondays - Fridays
Time Zone: TBA
Start Date : January 2024

• Manage accounts receivables and keep up-to-date records
• Coordinate with healthcare providers and insurance companies for claim submission and follow-up
• Generate revenue by making payment arrangements, collecting accounts and monitoring and pursuing delinquent accounts
• Collect delinquent accounts by establishing payment arrangements with patients, monitoring payments and following up with patients when payment lapses occur
• Maintain Medicare bad-debt cost report
• Secure outstanding balance payments for care of employees
• Verify insurance eligibility for patients and ensure timely payment
• Handle denied claims and appeal if necessary
• Reconcile payments and post to patients' accounts
• Maintain compliance with HIPAA regulations
• Handle patient inquiries regarding their accounts
• Must have a DME/Orthopedics/Podiatry experience

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.

• Permanent Work From home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Competitive salary