Careers

HR Manager

JOB DESCRIPTION:

• Reports directly to the General Manager.
• Assists top and line management in achieving the company’s objective of fostering harmonious Relationship with its human resources.
• Oversees activities in selection and recruitment of competent people and provide them with opportunities for advancement and self-development.
• Formulating policies and programs that will serve the requirements of the company and administer the same fairly to all employees.
• Provide technical services such as but not limited to counseling and coaching, and assistance to the operating management in relation to their personnel functions in promoting satisfactory work environment.
• Formulate and implements the training and development system of the company to uplist its human resource competence and productivity
• Sees that all employees are treated equally and fairly in the application of company policies, rules and regulations and in services rendered to them.
• Helps effect organizational changes and development to achieve the company’s goal and objectives.
• Prepares departments budget (execution, midterm plans) and analyze actual results.
• Conceptualize and formulates cost savings measure for the department to support the company in achieving the IBT set by the corporate.
• Concurs request of payments, petty cash vouchers, and ensure that all financial transactions of HRAD are in accordance with the existing policies and procedures.
• Regularly coordinates with association related to HR functions, DOLE and other related government agencies to ensure the company’s activities are within legal boundaries.
• Regularly coordinates with the company
• s service providers likewise monitors and evaluate their performance.
• Oversees HRAD staffs activities including monitoring and evaluation of their performance.
• Regularly reports accomplishments, plans, and operating activities during Managers meeting.
• File necessary reports associated with HRAD administrative activities.
• Develops and Implements New Hire Orientation procedures and instructions, and assist in development and implementation of corporate training activities.
• Manages all company wide activities and corporate events
• Performs other tasks that may be assigned from time to time

Medical Biller

As a medical billing specialist, you will take the data provided by the medical coders and use it to compile and submit claims to insurance companies and then subsequently bill patients. Day-to-day responsibilities vary from location to location, but often include:

JOB DESCRIPTION:

• Collect delinquent accounts by establishing payment arrangements with patients, monitor payments and also follow-up with patients when/if payment lapses occur.
• If necessary, work with collection agencies and small claims court to collect on delinquent accounts.
• Maintains Medicare bad-debt cost report by tracking billings; monitoring collections; compiling information.
• Initiates claims against estates by monitoring deaths and unpaid accounts.
• Secures outstanding balance payments for care of hospital employees by establishing payroll deductions; obtaining signatures for automatic transfers.
• Maintains work operations by following policies and procedures; reporting compliance issues.
• Protects hospital value by keeping collection information confidential.
• Adheres to professional standards, hospital policies and procedures, federal, state and local requirements.

QUALIFICATIONS:

• Candidate must possess at least a Vocational Diploma / Short Course Certificate, Bachelor's/College Degree , any field.
• At least 1 year(s) of working experience in the related field is required for this position.
• Applicants must be willing to work in Iloilo City / Alabang site.
• Preferably 1-4 Yrs Experienced Employees specializing in Customer Service or equivalent.
• Full-Time position(s) available.

USA

Client Account Manager (GA group)

Division/ Department: Billing

JOB SUMMARY :

Oversees and/or performs all tasks related to medical billing for specific clients. Coordinates workflow and communication between the client and Pettigrew. Monitors offshore resources for productivity and quality assurance.

General Job Responsibilities :

• Addresses all new work AR within 3 days of receipt on average
• Works Clearinghouse rejections daily
• Works with WSI or WSP staff and management to maintain Days in AR at 45 days or less and that 90+ aging is 15% or less of total AR
• Reviews and resolves aged AR; (objective is to have no more than 5% in any bucket over 91 days); Provide reasoning for any buckets above this percentage
• Applies appropriate appeals process where needed
• Resolves denied claims timely; minimize TLE's; works with carriers on claim resolutions
• Ensures appeals process is being followed according to Pettigrew Policy
• Assists with EOM Process as needed.
• Communicates with clients and their staff on a daily basis to resolve issues or errors.
• Communicate to management any negative trends; if applicable
• Ensures strict confidentiality of patient and financial records to comply with PHI, ePHI and HIPAA
• Where applicable: releases claims daily and additionally when new providers are approved by carriers. For MicroMD clients, bills claim no less than every two days.
• Where applicable: Monitors eBridge to ensure work is being completed within 3 days of receipt.
• Manages credit balances and works with clients to refund patients.
• Review, acceptance, and understanding of our workplace culture statement.
• The responsibilities listed in this job description are general descriptions of work assigned, duties and responsibilities may not be limited to just these responsibilities.

Work Experience Requirements:

• Knowledge of Microsoft Office, Outlook, Google Suites, Data Entry skills; knowledge of paperless processes
• Ability to interact and communicate with people over the telephone, often in stressful situations
• Ability to communicate effectively, both orally and in writing
• Ability to gather data, compile information, and prepare reports
• Ability to use independent judgment and to manage and impart confidential information
• Records maintenance skills; both manual and scanned documents
• Knowledge of medical insurance claims procedures and documentation

Education Requirement(s):

• GED or high school diploma required; associate’s or bachelor’s degree preferred
• at least 3-5 years of business experience with an emphasis on the medical field; banking/financial institution experience a plus

USA

Client Account Manager (CAM)

Division/ Department: Billing

JOB SUMMARY :

Oversees and/or performs all tasks related to medical billing for specific clients. Coordinates work flow and communication between the client and Pettigrew. Monitors offshore resources for productivity and quality assurance.

General Job Responsibilities :

• Processes billings to third party carriers and patients; maintain supporting documentation files via online archive (scans)
• Use online tools to verify eligibility to ensure a “clean” claim
• Accesses client EMR to capture charges and payments if applicable; maintain ADT interface for clients if applicable.
• Keys data and/or uploads to offshore resources: manual and/or automated transactions and verifies accuracy of input by balancing to both charge and deposit reports on a daily basis
• Research and respond by telephone and in writing to client and patient inquiries regarding billing issues and problems within 24 business hours.
• Report credit balances on a monthly basis to the client; adjust balances once checks are issued and note accounts.
• Process patient payments over the phone utilizing PCI affiliated tools.
• Resolve clearinghouse rejections daily
• Manage accounts for turn over to a collection agency or adjust off to bad debt based on client preference.
• Communicates with clients and their staff on a daily basis to resolve issues or errors.
• Communicate to management any negative trends.
• Ensures strict confidentiality of patient and financial records to comply with PHI, ePHI and HIPAA
• All other tasks and duties as assigned
• Review, acceptance, and understanding of our workplace culture statement.
• The responsibilities listed in this job description are general descriptions of work assigned, duties and responsibilities may not be limited to just these responsibilities.

Work Experience Requirements:

• Knowledge of Microsoft Office, Outlook, Google Suites, Data Entry skills; knowledge of paperless processes
• Ability to interact and communicate with people over the telephone, often in stressful situations
• Ability to communicate effectively, both orally and in writing
• Ability to gather data, compile information, and prepare reports
• Ability to use independent judgment and to manage and impart confidential information
• Records maintenance skills; both manual and scanned documents
• Knowledge of medical insurance claims procedures and documentation

Education Requirement(s):

• GED or high school diploma required; associate’s or bachelor’s degree preferred
• at least 3-5 years of business experience with an emphasis on the medical field; banking/financial institution experience a plus

USA

Credentialing Coordinator

Division/ Department: Administrative

JOB SUMMARY :

This position interacts directly with clients to assist them with application and participation with third party insurance carriers.

General Job Responsibilities :

• Manage all credentialing tasks for specific division.
• Coordinate Location and Provider profiles/signatures with clients and their facilities.
• Secure applications, complete and secure necessary attachments and signatures to compile a complete application. Monitor initial request and submission time on each application for back-up.
• Submit applications and monitor for approval; follow-up on applications every 3-6 weeks based on carrier guidelines.
• Call Carriers with issues or guidance when needed
• Maintain OneApp for all client credentialing in order to document steps taken and time involved; update CDS with every new approval and communicate to the appropriate teams.
• Respond to clients promptly and communicate timeline on specific carrier guidelines; provide clients with monthly update of credentialing status.
• Work with team members to resolve credentialing questions and issues
• Ability to work with carriers in all states and different MACS; research carrier requirements and applications for accurate submissions.
• Create and maintain CAQH as applicable.
• Other projects and duties as assigned
• Ensures strict confidentiality of patient and financial records to comply with PHI, ePHI and HIPAA
• Review, acceptance, and understanding of our workplace culture statement.
• The responsibilities listed in this job description are general descriptions of work assigned, duties and responsibilities may not be limited to just these responsibilities.

Work Experience Requirements:

• Experience with Excel, Power Point, Microsoft Office, Internet Explorer, Outlook, Google Office Suite and ability to learn new technology at a rapid pace
• Demonstrates effective and high level of professional communication skills (verbal and written)
• Position mandates a disposition of a high level of detail for success.
• Ability to work in a fast paced environment, demonstrate problem solving skills, demonstrate strong organizational skills and be a team player

Education Requirement(s):

• Associate’s or bachelor’s degree (preferred but not mandatory) plus 3+ years of experience that is directly related to the duties and responsibilities or RCM in general.

USA

Credentialing Manager

Division/ Department: Administrative

JOB SUMMARY :

This position interacts directly with clients to assist them with application and participation with third party insurance carriers. Oversees all Credentialing and EDI Enrollments.

General Job Responsibilities :

Credentialing

• Manage all credentialing tasks
• Review all emails pertaining to Credentialing. Add to workload when necessary. Check that responses are being added to OneApp and Status reports. Answer questions that arise. Research when necessary.
• Contact providers or managers to obtain required information and signatures for applications
• Assign applications to be completed and reviewed for proper documentation
• Monitor initial request, submission time and follow up on each application. Redirect when needed
• Monitor all applications for approval.
• Review follow up notes and status report weekly and submit status to provider
• Call carriers with issues or guidance when needed
• Maintain OneApp for all client credentialing in order to document steps taken and time involved
• Respond to clients promptly and communicate timeline on specific carrier guidelines
• Work with team members to resolve credentialing questions and issues
• Work with carriers in all states and different MACS; research carrier requirements and applications for accurate submissions.
• Unlock provider’s Pecos accounts when needed
• Complete and submit all Pecos enrollments
• Monitor all Pecos enrollments for provider signatures
• Check Pecos status weekly, troubleshoot any problems or delays
• Review OneApp and PI periodically and follow-up with staff to update or add notes as needed
• Address changes – update files in software so that claims, statements, appeals and letters all go out with correct address
• Train staff when necessary
• Interview and work closely with HR for staffing purposes

EDI

• Review all email pertaining to Claim Submission, ERA and EFT
• Queue enrollments and notify team when necessary
• Set up all logins and access for (PM) PI
• Enter information into Practice insights
• Assign or complete and submit enrollments when necessary
• Complete online enrollments when necessary
• Assign or register for websites to process online enrollments
• Review PI, TOPS, and websites for problems and proper set up
• Add clearinghouse and payer ID to TOPS to route claims correctly
• Troubleshoot submissions, connection problems, rejected claims, ERAs not received
• Access ERAs when escalated by the AR team
• Troubleshoot with Software Director if a transmission error occurs
• Review TOPS, PI and eBridge to see what is received in paper format, add enrollments as necessary
• Train staff on completing and submitting enrollments
• Train staff on how to troubleshoot EDI problems
• Train AR staff how to look up payments/claims and pull EOBs

InstaMed

• Set up logins and access for clients’ and PETTIGREW staff
• Complete and submit client enrollments for merchant accounts once approved update set up in TOPS
• Update call center logins so staff can accept payments for new merchant account
• Complete and submit request for statements
• Review and approve proofs for statements

Websites – Assign to team. Help when necessary.

• Register for websites
• Create logins
• Update and attest to provider information
• Review websites for EFT/ERA set up
• Assign team members to work on website tasks

TOPS – (assigned due to security level)

• Review accounts for AR when they cannot determine the reason for claim rejection.
• Update clearinghouse and payer ID as it is transferred to PI
• Load new providers
• Update addresses as needed. POS and payment address
• Run submitted claim report to check for payers going to incorrect clearinghouse
• Load contract fees

General

• Review, acceptance, and understanding of our workplace culture statement.
• The responsibilities listed in this job description are general descriptions of work assigned, duties and responsibilities may not be limited to just these responsibilities.

Work Experience Requirements:

• Experience with Excel, Microsoft Office, Internet Explorer, Gmail, Google drive and ability to learn new technology at a rapid pace
• Demonstrates effective and high level of professional communication skills (verbal and written)
• Position mandates a disposition for a high level of detail for success.
• Ability to work in a fast paced environment, demonstrate problem solving skills, demonstrate strong organizational skills and be a team player
• Must be able to prioritize efficiently and be able to switch gears at a moment’s notice.
• Experience working all aspects of the billing cycle, knowledgeable about clearinghouses and EDI processes.
• Hands on experience with credentialing government and commercial insurances.

Education Requirement(s):

• College Degree plus 5+ years of experience that is directly related to the duties and responsibilities or the equivalent in hands on experience in a working environment
• Management experience required

Iloilo, Philippies

Call Center Agent

JOB DESCRIPTION :

• Handles inbound and outbound calls.
• Handles customer requests, complaints, billing inquiries and other related concerns with the highest degree of courtesy and professionalism to resolve customer issues with one call resolution.
• Prepare complete and accurate work and update customer files.
• Communicate effectively with individuals/team in the program to ensure high quality and timely expedition of customer request.
• Effectively transfer misdirected customer requests to the appropriate party.
• Demonstrate continued and consistent proficiency in most of the skill set utilized within the call center based on WorldSource’s practices and operations.
• Communicate with customers using web-based tools and demonstrates the associated proficiency and grammar.
• May be assigned to work for another department depending on the business need.
• Able to multitask and work well under pressure.
• May be required to work in one or multiple queues or skill set over various customer contact channel.
• Contribute ideas on ways to resolve problems to better serve the customer and/or improve productivity.
• Participate in activities designed to improve customer satisfaction and business performances.

Iloilo, Philippies

Medical Biller

JOB DESCRIPTION :

As a medical billing specialist, you will take the data provided by the medical coders and use it to compile and submit claims to insurance companies and then subsequently bill patients. Day-to-day responsibilities vary from location to location, but often include:

• Collect delinquent accounts by establishing payment arrangements with patients, monitor payments and also follow-up with patients when/if payment lapses occur.
• If necessary, work with collection agencies and small claims court to collect on delinquent accounts.
• Maintains Medicare bad-debt cost report by tracking billings; monitoring collections; compiling information.
• Initiates claims against estates by monitoring deaths and unpaid accounts.
• Secures outstanding balance payments for care of hospital employees by establishing payroll deductions; obtaining signatures for automatic transfers.
• Maintains work operations by following policies and procedures; reporting compliance issues.
• Protects hospital value by keeping collection information confidential.
• Adheres to professional standards, hospital policies and procedures, federal, state and local requirements.

QUALIFICATIONS :

• Candidate must possess at least a Vocational Diploma / Short Course Certificate, Bachelor's/College Degree , any field.
• At least 1 year(s) of working experience in the related field is required for this Position.
• Applicants must be willing to work in Iloilo City / Alabang site.
• Preferably 1-4 Yrs Experienced Employees specializing in Customer Service or equivalent.
• Full-Time position(s) available.

Iloilo, Philippies

Human Resource Manager

JOB DESCRIPTION :

• Reports directly to the CEO and Executive Vice President /General Manager/ Head Of Operation – Asia.
• Assists top and line management in achieving the company's objective of fostering harmonious relationship with its human resources.
• Oversees activities in selection and recruitment of competent people and provide them with opportunities for advancement and self-development.
• Formulating policies and programs that will serve the requirements of the company and administer the same fairly to all employees.
• Provide technical services such as but not limited to counseling and coaching, and assistance to the operating management in relation to their personnel functions in promoting satisfactory work environment.
• Formulate and implement the training and development system of the company to uplist its human resource competence and productivity.
• Sees that all employees are treated equally and fairly in the application of company policies, rules and regulations and in services rendered to them.
• Helps effect organizational changes and development to achieve the company's goal and objectives.
• Prepares the department's budget (execution, midterm plans) and analyze actual results.
• Conceptualize and formulates cost savings measures for the department to support the company in achieving the IBT set by the corporate.
• Concurs request of payments, petty cash vouchers, and ensure that all financial transactions of People and Culture are in accordance with the existing policies and procedures.
• Regularly coordinates with association related to People and Culture functions, DOLE and other related government agencies to ensure the company's activities are within legal boundaries.
• Regularly coordinates with the company's service providers likewise monitors and evaluates their performance.
• Regularly reports accomplishments, plans, and operating activities during Manager’s meetings.
• Develops and Implements New Hire Orientation procedures and instructions, and assists in development and implementation of corporate training activities.
• Manages all company wide activities and corporate events.
• Performs other tasks that may be assigned from time to time.

JOB SPECIFICATIONS :

• Candidates must have at least 7 years of Solid Human Resources experience.
• At least 2 years of Management experience on the same field.
• Candidates must also possess a strong foundation in all facets of HR.
• Candidates must have strong organizational skills.
• Must have good communication skills.
• Adept in counseling and mentoring.

Chennai, India

AR Caller / Seniors

Job Code: WSI-AR-XXXX

Department: AR

Function Category: Medical Billing

Group/Grade: 1C

Designation: Analyst–AR

Reporting to: Team Leader -AR

Role Details :

This role is primarily working on account receivables

Area of responsibility :

• Delivering 100% production on account receivables
• Observing and learning on account specifics, knowledge's in various scopes
• Providing inputs and taking Initiatives for project improvement
• Being a team player
• Performing account manual test.
• Delivering Quality Percentage as per SLA.
• 100% Individual Attendance

Behaviour Competencies / Knowledge required and desirable :

• Analysing Skills as being an AR
• Ability to Understand and deliver as per client needs
• Internal and external Communication skills
• Maintaining Confidentiality as per HIPAA
• Basic RCM knowledge

Excellent skills in (desirable) :

• Proficient in MS office
• Typing Skills
• Communication Skills

Working Relationships/ Span of the role :

• Internal - Other AR team members, SME & Team Leader
• External - NA

Qualifications :

• Any Graduate

Experience (No. of years) :

• 0.5-2 Years of relevant experience

Location: Chennai

Other special requirement: NIL

Availability of role: High

Criticality of the role: Medium

Growth: Horizontal

Chennai, India

QAE – Quality

Job Code: WSI-Quality-1D

Department: Quality

Function Category: Medical Billing/AR

Group/Grade: 1D

Designation: QAE – Quality

Reporting to: Assistant Manager - Quality

Role Details :

This role is primarily focuses on performing on all billing and AR audits

Area of responsibility :

• Should have the end to end RCM knowledge and be capable to audit Demo, Eligibility, Charge Entry, Payments, Rejections, AR follow up and Denials
• To do Focus and Process audit
• To conduct ‘Ramp up’ meeting with new agents and provide daily feedback
• Providing advice, ideas and feedback to the team on meeting quality standards
• To take initiative in addressing the global issues
• Should provide daily feedback on the errors with corrective and preventive actions
• To be part of new projects transition for assigned project
• To learn new specialties, process/scopes
• Should perform audits for the minimum 5% or more
• Identifying inefficient or ineffective users and giving constructive feedback for their improvement
• Need to prepare daily and weekly reports
• Need to prepare the Monthly quality reports and conduct monthly meeting with the operation team
• Should identify the process gap’s and provide feedback to the operation team
• Should address focussing and improvement areas for each project
• Should address the top errors which impact the quality score and provide the quality and error trends
• Account Manual questions should be prepared
• Should monitor the agent’s calls and provide the appropriate feedback

Behaviour Competencies / Knowledge required and desirable :

• Reporting Research Results
• Analyzing & Auditing Skill
• Ability to Understand Process and deliver as per client needs
• End to End RCM Knowledge
• Internal Communication
• Attention to Detail
• Administrative Writing Skills

Excellent skills in (desirable) :

• Proficient in MS office/ Typing Skills
• Good Analytical Skill
• Good Communication Skills
• Coaching Skills

Working Relationships/ Span of the role :

• Internal - QAE’s, SQAE, Assistant Manager
• External - Clients (Specify name if any)

Qualifications :

• Graduate in any Stream or equivalent;

Experience (No. of years) :

• Minimum 4 Years of Healthcare Experience

Location: Chennai

Other special requirement: Should have the experience into Quality for the minimum of 1 year

Availability of role: High

Criticality of the role: High

Growth: Horizontal

Manila and Iloilo, Philippines

Key Responsibilities:

• Make accurate reports and effectively present them to the authorized users.
• In-charge of important documents and store them for utilization of the operations department.
• Add new material to file records and create new records as necessary.
• Responsible for the collection of data and the generation of reports to support the operation.
• Prepares report and statistical data for internal and external clients

Qualifications:

• Knowledgeable in Microsoft Excel and Google Spreadsheet.
• Excellent typing skills with a high level of accuracy at least 60-80 wpm.
• Strong written and verbal communication skills to effectively relate the data.
• Analytical skills that allow for the development of data-driven reports.
• Ability to manage time and prioritize projects to meet deadlines.
• Keen to details