Role Description Determine and verify insurance coverage and coordination of benefits from all sources for assigned area. Ensure proper adequate and timely billing to ensure prompt payment. - Confirm insurance coverage. - Determine necessity for pre-authorization and obtain authorization for scheduled procedures. - Determine financial responsibility for services to be provided. - Notify patients and/or practitioners of any services requested and/or referred that are not authorized by insurance. - Communicate with patients and practitioners regarding financial responsibility and insurance coverage issues. - Maintain detailed documentation in the patient account record of all billing activities. - Maintain documentation of claims processed as part of the daily claims reconciliation process. - Prepare and complete claims for commercial insurance companies, third party organizations and/or government or self payers. - Research, analyze and reconcile Medicare/Medicaid billing and reimbursement practices. - Consult with appropriate parties to resolve unbilled claims. - Review recent accounts for proper billing practices and reimbursement. Qualifications - High School diploma equivalency OR 1 year of applicable cumulative job specific experience required. - Required professional licensure/certification can be used in lieu of education or experience, if applicable. Benefits - Paid time off (PTO) - Various health insurance options & wellness plans - Retirement benefits including employer match plans - Long-term & short-term disability - Employee assistance programs (EAP) - Parental leave & adoption assistance - Tuition reimbursement - Ways to give back to your community

• Utilize various hospital/physician systems to verify patient, billing and claim information for accuracy • Perform compliant primary/secondary, tertiary and rebill billing functions which can include electronic, paper and portal submission to payers • Edit claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission • Respond timely to emails and telephone messages as appropriate • Communicate issues to management, including payer, system, or escalated account issues • Participate and attend meetings as requested, training seminars and in-services to develop job knowledge • Serve and protect the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards • Enhance billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments • Update patient demographics/insurance information in appropriate systems • Monitor claims for missing information, authorization, and control numbers (ICN//DCN) • Follow guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems • Secure needed medical documentation required or requested by third party insurance carriers • Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure • Utilize provider billing manuals to obtain billing guidelines and requirements • Import verification and escalation of import/export files • Special Handling billing included not limited to interim bills, overlap review, redistribution of money for correct claim creation • Resolve and research billing Rejections

Role Description We’re looking for a Support Specialist III, Imports to join our team in Manila. You will play a key role in onboarding new retailers to Lightspeed Retail by ensuring customer data is accurately formatted, validated, and imported into the platform. Working closely with Implementation Consultants, Support teams, and occasionally retailers, you will help deliver a smooth onboarding experience and ensure customers are set up for success from day one. This role requires strong attention to detail, excellent communication skills, and confidence working with large datasets and spreadsheets. You will leverage a range of internal tools to manage imports, troubleshoot data issues, and maintain high standards of data quality, becoming a subject matter expert in Lightspeed Retail data and onboarding processes. - Prepare retailer data by reviewing, cleaning, and formatting it to align with Lightspeed Retail requirements. - Identify and resolve data issues, communicating clearly with Implementation Consultants and retailers when needed. - Validate imports using internal tools, ensuring accuracy, completeness, and adherence to SLAs for go-live timelines. - Support retailers via Zendesk and Zoom, providing clear communication and data consultation where required. - Partner with Implementation Consultants to clarify requirements, timelines, and data expectations. - Contribute to continuous improvement by providing feedback on tools and automation to enhance import processes. - Learn and adapt to evolving data structures and import workflows as the platform develops. - Document processes and best practices to support team knowledge sharing and consistency. Qualifications - Exceptional English written communication skills. - Customer service or data-focused experience in a role that handles sensitive or PII data, such as banking, finance, or auditing. - Familiarity with Lightspeed Retail (X-Series, R-Series, or S-Series) or similar POS systems preferred. - Proven ability to work with large spreadsheets and knowledge of formulas and functions in Google Sheets or Excel (e.g., VLOOKUP, PIVOT TABLES, FILTER, JOIN, etc.). - Bonus: any experience with using or learning command-line tools, database browsers, or scripting languages is a plus. Benefits - Market-leading salary package. - Permanent work from home setup. - Coworking space available, if needed. - We follow the PH holidays! - Benefits you can enjoy from day one: - HMO for you and your 2 dependents (Maxicare). - 15 Vacation leaves. - 10 Sick leaves. - Government Mandated Benefits. - Food Allowance of 1000PHP per month. - Work from Home Allowance of 1000PHP per month. - Health and wellness benefit of 7500PHP per year. - Free access to Mental Health support and coaching services. - Opportunity to grow your career in a company that values internal mobility. - Exciting online and in-person events hosted regularly by our Manila Culture Club.

Role Description The Billing Specialist is responsible for Nursing Homes, Assisted Living Facilities, Group Homes, and Private Pay statements. - Process third-party billing, claim resolution, and adjudication - Manage FFS and PPS billing - Conduct census balancing and payor verification - Verify insurance and Medicaid coverage - Knowledge of Dual Coverage, MCR D, and Commercial Plans pertaining to Long Term Care - Assist with all customer billing inquiries in a courteous and professional manner - Enter fees and charges in Framework LTC - Prepare daily, weekly, and monthly pre-bills and account audits - Prepare daily, weekly, and monthly reports - Create statements and EOM summaries - Understand and work with residents on account balances - Follow all applicable government regulations including HIPAA - Other duties as deemed necessary by Billing Manager Qualifications - Able to read, write, speak, and understand the English language - Able to work in a fast-paced environment - Basic computer knowledge skills required - Basic math and analytical skills - Proficient in Microsoft Word, Excel, and Outlook required - Good organization/Attention to detail - Able to work at a moderate speed - Reliable - Problem solver - Able to work various shifts and days - Adaptability to an ever-changing environment Requirements - High School diploma or equivalent required - Two (2) years’ pharmacy billing experience required (long-term care preferred) - Framework LTC & General computer knowledge & 10-key Number Entry preferred - Knowledge of Sage preferred Physical Demands - May sit or stand seven (7) to ten (10) hours per day - The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, walk - May be necessary to work extended hours as needed - May lift and/or move up to 30 pounds - The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role Benefits - Medical, Dental, and Vision insurance - 401 (k) (available for Part Time & Full Time EEs) - Company Paid Life insurance - Short-term and Long-term disability insurance - Tuition reimbursement - Personal Time Off (PTO) - Competitive pay with annual performance reviews and merit-based raises - Career growth potential - Annual on-site voluntary Flu Vaccines - Employee referral bonus program