EPS INSURANCE BILLING SPECIALIST

Description

Position Summary: A clinic is seeking an EPS Insurance Billing Specialist to record, validate, and manage monthly billing, claim denials, and reconciliation of medical services. Key Responsibilities: 1. Comprehensive management of monthly billing to EPS and payment tracking. 2. Handling of claim denials, observations, and re-billing with EPS. 3. Coordination with various departments to resolve medical observations. The clinic requires an EPS Insurance Billing Specialist. **Main Responsibilities** * Record and validate medical services provided to EPS patients. * Prepare and submit **monthly billing** to EPS entities according to current agreements. * Verify coverage, deductibles, co-payments, and exclusions. SITEDS * Review clinical records, physician orders, and supporting documentation for billing purposes. * Manage **claim denials, observations, and re-billing**. * Coordinate with admissions, physicians, nursing, and pharmacy to resolve observations. * Track account statements, payments, and reconciliations. * Maintain up-to-date physical and digital EPS patient files. * Comply with deadlines and formatting requirements stipulated by each EPS entity. * Support internal and external audits. * Prepare production, billing, and EPS collections reports. **4. Position Requirements** **Academic Qualifications** Technical or university degree in: Administration, Accounting, Health Services Management, or related fields. **Experience** * Minimum **1–2 years** of experience in **EPS insurance billing** within clinics or hospitals. * Experience handling claim denials and billing recovery. **Technical Knowledge** * Familiarity with **EPS agreements** (e.g., Pacífico, Rímac, MAPFRE, La Positiva, among others). * Proficiency in hospital and EPS billing systems. * Knowledge of medical tariffs, packages, codes, and nomenclatures. * Intermediate-level Excel proficiency. * Basic understanding of health regulations and medical auditing. **Working Hours:** **Monday to Friday: 8:30 AM to 7:00 PM; Saturdays: 8:30 AM to 7:00 PM** **Location: Lince** Employment Type: Full-time Salary: S/.1,400.00 – S/.1,600.00 per month Workplace: On-site employment