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← Phòng Khám Chuyên Khoa Trị Liệu Thần Kinh Cột Sống Hoa Kỳ (Acc)

Patient Finance Officer

Phòng Khám Chuyên Khoa Trị Liệu Thần Kinh Cột Sống Hoa Kỳ (Acc) · Hồ Chí Minh
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Loại hình
Toàn thời gian
Hình thức
Tại văn phòng
Cấp bậc
Nhân viên
Ngành nghề
Tài chính / Ngân hàng
Mức lương
Thương lượng
Địa điểm
Hồ Chí Minh, Hồ Chí Minh, Hồ Chí Minh

Tổng quan

  • Insurance Claims and Direct Billing Administration:
  • 1 Indirect billing for self-reimbursement patients:
  • Provide medical certificates/documents for pay-and-claim patients to submit reimbursement claims.
  • Support patients with additional document requests or inquiries from insurance providers.
  • Review billing charges of insurance documentation fees (if applicable) by Front Desk team to ensure compliance to SOPs
  • 2 Direct billing for insured patients:
  • Process claims for direct billing patients and coordinate with insurance providers for guarantee of payment (GOP).
  • Verify patient insurance eligibility, coverage, pre-authorizations and direct billing benefits.
  • Explain insurance benefits, direct billing procedures, claim requirements and patient financial responsibilities to patients.
  • Coordinate with patients, clinical teams and insurance companies to obtain coverage confirmations, Guarantee of Payment (GOP), and required approvals.
  • Ensure invoices, claim forms, medical records, and supporting documentation are complete, accurate, and compliant with insurer requirements.
  • Prepare documentation to process deposit refunds for direct billing patients based on GOP.
  • Prepare, review, and submit insurance claims accurately and within agreed timelines.
  • Maintain accurate claim records and follow up with insurance companies on claim status, additional information requests, and claim resolution.
  • Accounts Receivable and Collections:
  • Monitor outstanding insurance receivables and proactively follow up with insurance companies to ensure timely payment.
  • Reconcile insurance payments against billed amounts and investigate discrepancies.
  • Inform clinics and the accounting team upon receiving claim settlements/payments to ensure accurate financial recording.
  • Resolve underpayments, overpayments and other payment-related issues.
  • Coordinate with the Accounting team to ensure timely receipt and reconciliation of insurance payments.
  • Support month-end reconciliation of insurance account receivables (AR).
  • Escalate overdue or unresolved collection matters to management when appropriate.
  • Claims & Denial Management:
  • Analyze rejected or denied claims to identify root causes and recommend corrective actions.
  • Prepare claim corrections, resubmissions, and appeals with appropriate supporting documentation.
  • Coordinate with doctors, clinical teams, Front Desk staff, and other departments to obtain information required for claim resolution.
  • Maintain claim denial records and monitor timely resolution.
  • Identify trends in claim denials and recommend process improvements to improve claim acceptance rates.
  • Insurance Partner & Patient Support
  • Maintain professional relationships with insurance companies.
  • Respond promptly and professionally to enquiries from patients, insurers or internal departments regarding insurance coverage, claims and direct billing services.
  • Assist in resolving insurance-related complaints or related issues.
  • Maintain up-to-date knowledge of insurance policies, products, and direct billing requirements.
  • Support the implementation of new insurance partners and related operational processes.
  • Compliance and Reporting:
  • Ensure billing and claims activities comply with applicable laws, direct billing contracts and internal policies.
  • Maintain accurate billing records and documentation.
  • Work closely with the Accounting Manager on AR reporting and month-end closing activities.
  • Collaborate with internal teams to improve billing and collection processes.
  • Provide additional support to the Financial Controller on finance-related tasks and ad-hoc assignments when required.

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