Team Lead for Healthcare Account (VOB) | Get a 21K Signing Bonus at A1M Solutions

Mandaluyong, Metro Manila, Philippines

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, OutsourcingIndustries

Requirements

At least 1 year BPO experience handling US Healthcare Insurance
Strong familiarity with U.S. Health Insurance (Medicare, Medicaid, Managed Care, Commercial plans)
Understanding of key benefit terminology (deductibles, co-insurance, OOP max, HMO/PPO, SNF benefits, PDPM, etc.)
Medical billing, prior authorization, or claims follow-up experience
Knowledge with Revenue Cycle Management (RCM) is an advantage
Skilled nursing facility (SNF) admissions or insurance coordination experience is a PLUS
Proficiency with payer portals such as Availity, NaviNet, and payer-specific platforms
Strong computer literacy and ability to navigate multiple systems simultaneously
Willing to work onsite in Shaw Blvd, Mandaluyong
Amenable to working night shift

Responsibilities

Oversee daily operations for all agents delivering high-quality and valued services
Conduct training and coaching, including insights and action plans to improve
Analyze and report on productivity and other metrics - such as attendance, end-of-day reports, and compliance with company protocols
Ensure that the client is updated on significant program activities, issues, and concerns through calls, emails, meetings, reports
Perform other supervisory tasks as required
Verify patient insurance eligibility and benefits through payer portals, phone calls, and verification tools
Review and document coverage details including deductibles, copays, coinsurance, out-of-pocket limits, and plan exclusions
Confirm network status, authorization requirements, and benefit limitations based on treatment type or service line
Obtain prior authorizations when required and track authorization status
Communicate benefit summaries and financial responsibilities to admissions, clinical, and billing teams in a clear, timely manner
Maintain accurate documentation in the EHR, practice management system, or verification platform
Identify potential coverage issues that may affect reimbursement and notify appropriate departments
Follow payer-specific guidelines and stay updated with coverage policy changes
Support efforts to reduce denials and improve clean-claim submission rates
Maintain patient confidentiality and adhere to HIPAA and organizational compliance standards

Skills

Team Leadership

Training

Coaching

Productivity Analysis

Metrics Reporting

Insurance Verification

Benefits Verification

Payer Portals

Prior Authorizations

EHR Documentation

Practice Management Systems

Compliance

A1M Solutions

Design and data support for government healthcare

About A1M Solutions

A1M Solutions specializes in providing design, data, and policy-informed support for government healthcare programs, with a focus on serving disadvantaged populations. The company leverages expertise in government healthcare programs, data analysis, and policy/legislation to design effective business strategies and enhance digital service delivery, utilizing agile research and insights to untangle complex problems and generate thoughtful solutions.

Chico, CA, USAHeadquarters

2018Year Founded

VENTURE_UNKNOWNCompany Stage

Consulting, Social ImpactIndustries

11-50Employees