Medical Claims Analysts

Medical Claims Representative Job Summary: Responsible for collections, account follow-up, billing, and allowance posting for assigned accounts. The Medical Claims Representative is a key role in our organization, responsible for ensuring timely resolution of outstanding claims and maintaining daily productivity/quality standards. The ideal candidate will...

JOB QUALIFICATIONSCompleted at least 2 years in collegeWith minimum 12 months experience of Healthcare Account Receivable/Collections in a BPO setting or environment (claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers)Familiarity with UB Claims and knowledge in UB04...

Hospice Billing Job DescriptionAt Cliniqon, we are seeking a highly skilled Medical Claims Specialist to join our team. As a key member of our healthcare revenue cycle team, you will be responsible for preparing and submitting accurate and timely billing claims for hospice services to Medicare, Medicaid, and private insurance companies.Key...

Job Title: PHRN in Metro ManilaJob Summary: We are seeking a highly skilled and experienced PHRN to join our team at Metacom Philippines.Responsibilities:Review medical claims for medical necessity and ensure compliance with company policies.Assess and interpret customer needs, requirements, and medical records to provide accurate and timely...

At Addmore Outsourcing Inc., we are seeking a skilled Healthcare Coding Specialist to manage patient billing and coding processes.Key Responsibilities:Coding and Billing: Assign accurate ICD-10, CPT, and HCPCS codes to patient diagnoses and procedures, ensuring compliance with current regulations and guidelines.Insurance Claims: Prepare and submit insurance...

Job Title: Claims Senior SpecialistAt Hunter's Hub Incorporated, we are seeking a highly skilled Claims Senior Specialist to join our team. As a Claims Senior Specialist, you will be responsible for ensuring that reimbursement claims are properly adjudicated and that customers receive exceptional service.Key Responsibilities:Properly adjudicate reimbursement...

Claims Associate role involves accurate logging, evaluation, and processing of claims, with a focus on sound business judgement and adherence to corporate policies and procedures. Job Description The Claims Associate is responsible for: Accurate logging of received claims from partner providers and/or clients Evaluation and prompt processing of...

Interviews, evaluates and classifies patients. Conducts social case management/social work intervention to patients referred with social, emotional or environmental problems affecting their medical situation; also those patients who are considered abandoned, neglected and victim of different types of abuse.Helps patient adjust to his environment conditions...

Medical Biller role requires processing claims for pediatrics clinics in USA, ensuring timely payment, denial investigation, and A/R recovery. Responsibilities: Posting payments and downloading ERA/EOB Investigating and appealing denied claims, correcting and resubmitting as needed Performing A/R recovery and collection Verifying patient...

Medical Billing and Coding SpecialistWe are seeking a detail-oriented and knowledgeable Medical Billing and Coding Specialist to join our healthcare team at Addmore Outsourcing Inc.Key Responsibilities:Coding and Billing: Accurately assign ICD-10, CPT, and HCPCS codes to patient diagnoses and procedures based on medical documentation, ensuring compliance...

Create Nightshift billing reports and maintain accurate records, ensuring timely payment processing and customer satisfaction through attention to detail and effective problem-solving skills.Enter data, post payments, track encounters, and submit claims electronically or on paper.Balance daily and monthly records, follow up on unpaid claims and denials, and...

Job Summary: Healthcare Claims Representative responsible for collections, account follow-up, billing, and allowance posting for assigned accounts. The Healthcare Claims Representative is responsible for collections, account follow-up, billing, and allowance posting for the accounts assigned to them. They will follow up with payers to ensure timely...

Work night shifts onsite during training in Mckinley, Taguig, and hybrid after.Key responsibilities include:Data and charge entry, payment posting.Encounter tracking to ensure all visits are captured.Submission of paper and electronic claims.Balancing on a daily and monthly basis.Follow up on all unpaid claims or denials.Development and mailing of patient...

Regulatory Affairs Analyst is responsible for ensuring company products comply with government regulations and are registered with relevant agencies. Key responsibilities include: Regulatory compliance and registration of company products Staying up-to-date on applicable regulations Excellent written and verbal communication skills ...

 Participates in strategy development meetings with the Chief Medical Officer (CMO) and Deputy CMO to develop and implement innovative procedures, regulations, and programs to improve efficiency, quality, and customer service of the Medical and Provider Services Division.  Key responsibilities include: Acts as co-lead in dealings with provider groups for...

Collaborate with healthcare providers and members to promote quality member outcomes, optimize benefits, and resource utilization. Collaborate with medical directors to interpret appropriateness of care and accurate claims payment. Manage appeals for services denied. Key responsibilities include: Conduct pre-certification, continued stay review, care...

Job Summary: Data Analyst responsible for monitoring exposure and claim data, improving data quality, and submitting financial reports. Job Responsibilities: Monitor various exposure and claim data sets and collaborate with business units and support teams to improve data quality and avoid financial penalties. Compile data, create reports from...

Are you ready to start your legaSEA? SEAOIL is looking for passionate talents to help make a difference in the lives of Filipinos and fuel their better future. Here's your chance to grow your career with the largest and leading independent fuel company in the country - join us as our next Supply Analyst – Voyage Analysis What is this role about?The role...

Work Set-Up: 2 to 4 weeks of onsite onboarding, followed by a transition to a work-from-home setupLocation: 19th, CyberOne, Eastwood Ave, Quezon City, 1800 Metro ManilaShift: NightshiftDuties and Responsibilities:1. Work Hold BucketsMake corrections to the following:Provider informationPatient insurance discrepanciesCredentialing informationPatient...

Experienced HCC Analyst / Risk Adjustment Coder sought to audit outpatient charts, validate ICD 10 diagnosis coding, and utilize industry-recognized references. Must have a bachelor's degree, active medical coding certification, and at least 1 year 6 months of HCC/Risk Adjustment experience. Competitive salary package, certification renewal sponsorship, and...