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Company’s overview:
Opticall BPO was founded in 2016 under one single precept, to become the leading organization in the Business Process Outsourcing Industry. Opticall is rapidly becoming one of the fastest growing BPOs, developing tremendous career opportunities, attractive compensation & benefit packages for our talented members in the countries where it operates.
With over 15 support departments such as Sales, Marketing, Finance, Human Resources, Call Center, Telemedicine, IT, Back-Office and many more, Opticall BPO offers a rewarding work environment, professional development, job stability, and once in a lifetime journey. We are happy to celebrate our success and include you in it.
1. Summary/Objective:
The Billing & Collections representative is responsible for the daily Managed Care collection process ensuring we are reimbursed appropriately for Managed Care orders, rebilling processes of insurance claims in order to collect the insurance reimbursement and follow-up on outstanding insurance orders.
2. Responsibilities:
? Ensure claims for franchise and corporate locations are billed timely, errors are corrected timely and payments are received timely.
? Process claims as needed on various company websites.
? Review claims daily in Trizetto to ensure all daily errors are corrected and resubmitted within 24 hours
? Work with corporate and franchise locations to ensure all weekly claim errors are corrected and claims are submitted timely.
? Work with Collections Lead to ensure root cause for any recurring errors is identified and resolved.
? Follow up on claims outstanding for more than 45 days to confirm receipt and adjudication status. Refile/correct as necessary to ensure processing.
? Call payers and also communicate via email on status of claims until payments are received
? Identify claims that need to be refiled, refile claims as needed and track to ensure adjudication
? Work with Billing Lead/Manager on resolving/identifying/analyzing any claim trends that need to be fixed/updated
? Ensure claims are billed accurately the first time to ensure high percentage of first pass claims
? Report claims needed to be patient billed
? Monitor aging buckets to ensure all claims greater than 60 days old are resolved timely.
? Work with collections lead and training on any potential areas of training needed for the stores.
? Ensure all collections questions submitted via FranConnect tickets are completed within 24 hours
3. Education and Experience:
Experience working independently and with teams to accomplish a shared goal.
Excellent knowledge of MS Office (particularly advance Excel)
Degree in finance, accounting or related field is preferred
US Insurance Billing experience a plus.
4. Skills Required:
Advanced English Level
Adherence to laws and best practices in regards to using the correct methods to solve problems
Quick typing
Comfortable dealing with numbers and the processing of financial information
Results-driven and patient
A high degree of attention to detail and trustworthiness
Excellent communication ability
Organizational and time-management skills
Teamwork skills
Ability to work independently and meet tight deadlines
Easy adaptation to change and fast learning with systems
Open to receive feedbacks
Ability to follow instructions
