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About the Role

This Japanese-English bilingual role is responsible for receiving, reviewing, and verifying provider claims to ensure charges comply with authorized services and insurance carrier billing procedures. The position also enters provider claims into the company’s system for further processing.

Responsibilities

• Receives provider invoices (medical claims) via email, post, etc. and logs invoice information in Excel tracker daily.
• Reviews and validates medical claims by verifying that billed charges correspond to services authorized in Guarantee of Payment (GOP) letters.
• Records medical claims in BiGGeR system for timely payment processing.
• Handles provider inquiries received by email and phone, investigates concerns, and delivers timely resolutions professionally.
• Collaborates with Operations, Medical Benefit Reviewers, Billing, and Network Service teams to resolve queries and outstanding issues.
• Maintains communication with supervisory and management teams, providing updates on situations impacting productivity.
• Ensures protection of private health and personal information by adhering to HIPAA and PCI compliance regulations.
• Participates in office activities, meetings, and task forces to improve processes.
• Completes additional duties as assigned by the Payment Manager.

Requirements

• Demonstrated customer service skills in the private sector.
• Claims/billing experience.
• Proficiency in Microsoft Office applications (Excel, Word, Outlook, PowerPoint).
• Knowledge of hospital/medical administration is a plus.
• Medical terminology certification is a plus.
• Experience with Electronic Data Interchange (EDI) is a plus.

Skills

• Japanese: Native level
• English: Business level

Location

• Japan

Work Type

• Onsite

Education Level

• Bachelor's degree in any field

About the Company

• International SOS is a global leader in health and security risk management, providing medical, security, and workforce wellbeing solutions to organizations around the world.