Medical Claims Specialist

2 weeks ago


Davao City, Davao, Philippines Connext Global Solutions Inc Full time
Medical Claims Specialist | Davao | 20K Sign-on Bonus (1633)

Medical Administration (Healthcare & Medical)

Connext Global Solutions is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.

We are currently looking for an Medical Claims Specialist to support our client based in the US.

What's in it for you?

There's a lot to love about Connext. Here are some of the reasons why:

  • Competitive salary and bonuses
  • 25% Night Differential Pay
  • 20 Annual Leave Credits
  • Health, dental, and life insurance
  • Fun HR virtual and onsite events
  • Professional development and training opportunities
  • Employee assistance programs (EAP)
  • Employee volunteer and community service opportunities
  • Amenities for leisure and recreation
  • Certified Great Place to Work (2022)

What is the job?

The Medical Claims Specialist is responsible for managing hospital and/or physician billing collections, ensuring accurate and timely processing of claims, and facilitating prompt payment from payers. This role will also work closely with various insurance providers, including Medicare, Medicaid, Blue Cross, and commercial health insurance carriers, to ensure accurate and timely reimbursement for medical services rendered.

  • Examine medical claims to ensure accuracy and completeness.
  • Verify health insurance benefits and coverage for patients.
  • Follow up with payers regarding claim status and outstanding balances.
  • Identify and resolve issues preventing timely claim resolution.
  • Correct and resubmit claims as necessary to ensure prompt payment.
  • Maintain detailed documentation of all billing and collections activities.
  • Provide expert customer service to patients and insurance providers.
  • Ensure compliance with legal and regulatory requirements at all times.

What you bring to the job?

  • At least 1 year of experience with Claims processing (submitting and resubmitting corrected claims)
  • Familiarity with Medicare, Medicaid, and Blue Cross claim submission processes and requirements is a plus.
  • Excellent written and verbal communication skills in English
  • Have high energy, be a self-starter, great teammate and ready to roll up your sleeves to get things done
  • Comfortable in working with US-based client
  • Good tenure with previous companies (stays with companies for at least a year)
  • Willing to work onsite in 2nd Floor, Hai Global Building, Pryce Business Park, J.P. Laurel Avenue, Poblacion District, Davao City
  • Willing to work from 9:00 PM - 6:00 AM; Monday to Friday (Philippine Time)
Your application will include the following questions:

What's your expected monthly basic salary?

How many years' experience do you have as a Claims Specialist?

Information & Communication Technology

Connext Global Solutions helps businesses solve the staffing challenges and enable client growth with their innovative remote staffing and process outsourcing solutions. Connext powers small and medium enterprises by helping build, train, and manage excellent, highly functioning remote teams.

Originally established in 2014 to address specific pain points that we experienced in the traditional outsourcing model, Connext has grown from a local business services provider to a booming global enterprise with a growth rate exceeding 80%. We have more than doubled our growth since 2019 and now support middle-market companies across the United States and Europe.

Our client support centers are located Angeles City, Pampanga where we provide the highest caliber: Connext provides client-focused bespoke solutions to clients across all industries.

The Connext offshore team of industry experts include the following:

Senior CPAs, CPAs, Staff Accountants, and Accounting Techs

Real Estate Title and Escrow Specialists

IT/WEB Developers and Administrators

Nurses and Healthcare Claims Processors

QA and Data Analytics Specialists

Graphic Designers and System Engineers

HR and Payroll Service Professionals

Technical Support

Data Entry Specialists

Customer Service Representatives

and More

Core Values

Make It Fun

Be Transparent

Hire The Best

Take Ownership

Foster Teamwork

Do What's Right

Put Customers First

Go Above and Beyond

Connext Global Solutions helps businesses solve the staffing challenges and enable client growth with their innovative remote staffing and process outsourcing solutions. Connext powers small and medium enterprises by helping build, train, and manage excellent, highly functioning remote teams.

Originally established in 2014 to address specific pain points that we experienced in the traditional outsourcing model, Connext has grown from a local business services provider to a booming global enterprise with a growth rate exceeding 80%. We have more than doubled our growth since 2019 and now support middle-market companies across the United States and Europe.

Our client support centers are located Angeles City, Pampanga where we provide the highest caliber: Connext provides client-focused bespoke solutions to clients across all industries.

The Connext offshore team of industry experts include the following:

Senior CPAs, CPAs, Staff Accountants, and Accounting Techs

Real Estate Title and Escrow Specialists

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