Skip to main content
Boldr

Customer Specialist

RemotePhilippines only
Published
Role
Support
Experience
Mid
Employment
Full-time
Company size
Mid-size
Salary not disclosed
Check eligibility

Open to PH only. Set where you work from to check your eligibility.

No BS summary

Insurance Billing Specialist / Customer Specialist in the Philippines with 3+ years of DME billing and insurance reimbursement experience across eligibility verification, claims, appeals, and collections. Must know EOBs, CPT, HCPCS, ICD-10, HIPAA, CMS, ERISA, CRM/billing tools, Zendesk, Slack, Google Workspace, and MS Office.

Core skills

DME billingInsurance reimbursement

Required skills

CPTHCPCSICD-10HIPAACMSERISACRMNikoHealthZendeskSlackGoogle DriveGoogle SheetsGoogle DocsMS Office

What you'll do

  • Verify insurance: Conduct timely and accurate eligibility checks and benefit investigations through payer portals and phone outreach to ensure claims are submitted correctly from the start
  • Submit and track: Enter and monitor Durable Medical Equipment (DME) claims across multiple platforms, troubleshoot billing issues, and proactively follow up to reduce denials and accelerate reimbursement
  • Review and resolve: Analyze explanation of benefits (EOBs) for errors, missing payments, or misapplied patient responsibility, then determine and execute the correct resolution path
  • Draft and submit: Write detailed, well-supported appeals that address denial reasons clearly and improve chances of successful claim recovery
  • Investigate and escalate: Work aging reports weekly to identify unpaid or incorrectly paid claims, collaborate with payers or escalate internally as needed to drive resolution
  • Communicate clearly: Provide clear and empathetic responses to patients with billing questions, helping them understand their benefits and out-of-pocket costs without confusion
  • Collaborate cross-functionally: Work with Billing teammates, Customer Experience, Fulfillment, and cross-functional partners to identify process gaps and improve billing operations end to end
  • Leverage AI: Use AI-enabled tools that assist with eligibility, claims validation, and documentation to improve efficiency while maintaining billing accuracy and compliance
  • Support families: Ensure timely access to medically necessary DME by reducing billing friction, shortening reimbursement cycles, and ensuring every claim is processed with care

What they require

  • Curious and authentic, just like us! #beboldr
  • An analytical and critical thinker, with an eye for even the most minute of details
  • Passionate about client satisfaction.
  • Self-starter, motivated, and results driven
  • Ability to function effectively in a fast-paced environment and can quickly learn new skills to meet the organization’s needs.
  • Organized and detail-oriented.
  • Always up-to-date in documentation and record creation.
  • 3+ years of direct experience in DME billing and insurance reimbursement, managing the full claim lifecycle from eligibility verification through appeals and collections.
  • Confidence reviewing EOBs, identifying payment discrepancies, denials, and adjustments, and taking appropriate follow-up action with minimal oversight.
  • A working understanding of Current Procedural Terminology (CPT), HCPCS, ICD-10, and relevant DME billing regulations such as HIPAA, CMS, and ERISA, applied accurately in your daily work.
  • Strong written communication and interpersonal skills, able to explain complex billing issues clearly and professionally to patients, internal teams, and payers.
  • Confidence to ask questions when unsure about something or flag issues to the appropriate teams.
  • Proficiency in CRM/billing software and customer service platforms (NikoHealth, Zendesk, Slack).
  • Strong knowledge of cloud-based applications (Google Drive, Google Sheets, Google Docs) and MS Office applications.
  • A team-first mentality with high attention to detail and a proven ability to produce high-quality work consistently, even at high volume.
  • Openness to using AI tools that improve workflow efficiency and accuracy, and willingness to adapt as the team adopts new technologies.

Boldr is the first global B-Corp dedicated to delivering world-class Client experiences while creating access to dignified, meaningful work in communities around the world.

Professional ServicesEnterprise
Salary not disclosed