Reimbursement Specialist (Healthcare | ONSITE - Ortigas + 25 Night Differential)

Connext Global Solutions is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.

We are currently looking for an Reimbursement Specialist who will be working with Connext's Client in the United States of America.

What's in it for you

• Competitive compensation
• Perfect Attendance Bonus
• Life insurance
• HMO Insurance
• Great company culture
• Annual Merit Increase
• 25% Night Differential
• Onsite in Ortigas

What is the job

The Reimbursement Specialist is responsible for researching, analyzing, and negotiating pre- and post-payment proposals to maximize reimbursement outcomes. The role reviews claims and reimbursement information, manages negotiation follow-ups, documents negotiation activities, and escalates complex claims to the onshore Negotiations team when additional guidance is needed.

• Research and negotiate pre- and post-payment proposals on a daily basis.

• Analyze claims, reimbursement rates, and supporting information to determine appropriate negotiation positions.

• Review proposed negotiations and identify opportunities to maximize reimbursement outcomes.

• Make outbound calls to follow up on negotiation proposals and ensure responses are reviewed.

• Handle negotiation-related follow-ups through phone calls, emails, and other communication channels.

Required Qualifications:

• High school diploma or equivalent combination of education and relevant work experience.

• Minimum of two (2) years of experience in payment/reimbursement negotiation, claims management, medical billing, or healthcare revenue cycle management.

• Experience in Microsoft Office Suite.

• Must have stable employment history.

• Experience analyzing claims and reimbursement information.

• Proven ability to evaluate reimbursement rates and negotiate payment proposals.

• Proven ability to conduct productive discussions and secure appropriate reimbursement outcomes.

• Proven ability to create and follow action plans to achieve required outcomes.

• Proven ability to handle sensitive payment information while maintaining confidentiality and security.

• Demonstrates strong analytical skills with the ability to identify discrepancies and determine appropriate solutions.

• Demonstrates strong time-management skills and ability to manage multiple claims simultaneously.

• Clear and coherent both written and verbal communication skills in English.