Bill Review Associate I at Genfinity Philippines, Inc.

Mandaluyong, Metro Manila, Philippines -

Full Time

Start Date

Immediate

Expiry Date

15 Jan, 26

Salary

0.0

Posted On

17 Oct, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Billing, Healthcare Claims Review, Workers’ Compensation, CPT Coding, ICD Coding, HCPCS Coding, Analytical Skills, Attention to Detail, Communication Skills, Microsoft Office, Medical Documentation, Reimbursement Policies, Procedure Coding, Compliance, Cost Containment, Quality Improvement

Industry

Outsourcing and Offshoring Consulting

Description

The Bill Review Associate I is responsible for analyzing and auditing medical billing data to ensure accuracy, proper coding, and compliance with reimbursement policies. The role supports cost containment and quality improvement in healthcare services through effective bill review and interpretation of medical documentation. Key Responsibilities: Audit and evaluate payment determinations, reconsiderations, and re-reviews of medical billing data. Analyze lower-level technical bills including high-level office visits, medical reports, and records to determine accuracy. Review medical reports, diagnostic results, and treatment plans to validate proper reimbursement or recommend adjustments. Assist in assigning procedure codes, including complex and comprehensive exam codes. Maintain a reference library of internal and external reimbursement policies and coding guidelines. Conduct test studies for the Compliance Team, meeting aggressive deadlines while ensuring accuracy and completeness. Ensure compliance with all company policies, procedures, and applicable regulations. Perform other related duties as assigned. Qualifications: Bachelor’s degree in a healthcare or business-related field, or equivalent experience Minimum of 1–2 years of experience in medical billing or healthcare claims review, with direct experience in Workers’ Compensation bill review processing required. Certification in medical coding (CPC, CCS, or equivalent) preferred. Strong knowledge of Workers’ Compensation billing processes, rules, and fee schedules. Proficient in applying CPT, ICD, and HCPCS coding standards. Excellent attention to detail and analytical skills. Familiarity with medical billing software and Microsoft Office tools. Strong written and verbal communication skills. Ability to manage workload independently within established procedures. ✅ Onsite training then will transition to hybrid setup in Mandaluyong City (1 day onsite, 4 days remote) ------------- All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, ethnicity, age, disability, marital status, or any other characteristic protected by law. Genfinity as an Equal Opportunity Employer, believes in each person’s potential, and we’ll help you achieve yours. All information will be kept confidential according to EEO guidelines. Privacy Notice & Consent We value your privacy. By submitting your information through this form, you are applying for a position at Genfinity Philippines, Inc. and voluntarily providing personal information, including your name, contact details, and resume. This information will be collected and processed solely for recruitment purposes, including evaluating your qualifications, assessing your skills, verifying your background, and contacting you about your application. Your personal data will be processed in accordance with the Data Privacy Act of 2012. You have the right to access, correct, or withdraw your data at any time. For more information, please refer to our Privacy Policy or contact our Data Protection Team at dpo@genfinity.net . By submitting this form, I acknowledge that I have read and understood the above Privacy Notice and hereby give my free, informed, and voluntary consent to the collection and processing of my personal information by Genfinity Philippines, Inc. for recruitment purposes.

Responsibilities

The Bill Review Associate I audits and evaluates medical billing data to ensure accuracy and compliance with reimbursement policies. This role involves analyzing medical reports and assisting in coding procedures to support cost containment and quality improvement in healthcare services.