Medical Claims Analysts

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...

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...

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...

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...

Job OverviewSOURCETECH SOLUTIONS INC. is seeking a highly skilled Medical Administration Specialist to manage day-to-day healthcare administration tasks, ensuring efficiency and compliance with industry standards.Key ResponsibilitiesLiaise with key stakeholders for the administration of Health Plan, Insurance Coverage, and Dental Program, coordinating...

Job Title: Medical Appeals SpecialistWe are seeking a skilled Clinical Nurse Appeals Writer to join our team at Dencom Consultancy.About the Role:As a Clinical Nurse Appeals Writer, you will be responsible for writing appeals for denied claims. You must have at least 3 years of clinical experience and solid knowledge of MCG/InterQual criteria.Key...

 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...

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...

Job Description: The successful candidate will liaise with internal and external stakeholders to ensure compliance with Philippine laws and Medical Center policies. They will document processes, perform quality assurance activities, and submit reports to management. Key goals include improved client care, process efficiency, and safe patient care. The ideal...

Collaborate with internal and external stakeholders to ensure compliance with Philippine laws and Medical Center policies, standards and guidelines. Document and update processes through quality assurance reviews, promoting improved client care, efficiency and safe patient care. Maintain quality assurance activities, control tools and techniques, attending...

Hospice Billing SpecialistAt Cliniqon, we are seeking a skilled Hospice Billing Specialist to join our team. The ideal candidate will have a strong background in medical billing, with a focus on hospice services. Key responsibilities include: Preparing and submitting accurate and timely billing claims for hospice services to Medicare, Medicaid, and private...

Graduate of any 4-year college course, preferably medical allied. Experience in insurance/HMO and value adding services preferred. Proficient in MS Office Programs (MS Word, Excel, and PowerPoint). Good communication, coordination, and negotiation skills. Can start ASAP. Preferably an experienced employee specializing in Healthcare and Insurance/HMO –...

Job Requirements:- 3+ years of clinical experience as a PHRN/USRN.Key Responsibilities:- Developing and writing appeals for denied claims (I/OP) with expertise in MCG/InterQual criteria.Essential Skills:- Willingness to work onsite and on a night shift schedule.How You'll Make a Difference:As a skilled nurse appeals writer, you will play a critical role in...

About the RoleCliniqon is seeking a skilled Hospice Billing Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for ensuring the timely and accurate billing of hospice services to Medicare, Medicaid, and private insurance companies.Key ResponsibilitiesPrepare and Submit Accurate Billing Claims: Verify patient...

Job Summary:We are seeking a skilled Dialysis Nurse to join our team at Metacom Philippines. The ideal candidate will have a strong background in clinical nursing and excellent communication skills.Responsibilities:- Review medical claims for medical necessity- Assess and interpret customer needs, requirements, and medical records- Identify solutions to...

**Career Opportunity in the Philippines**Nordic Jobs Worldwide is seeking a Finnish-speaking Service Desk Analyst to join our team in Manila, Philippines. As a Service Desk Analyst, you will be responsible for providing technical support to our clients in Finnish, handling first-line incidents, and troubleshooting issues.**Key Responsibilities:**Handle...

Clinical Denials Clinician recovers revenue through intelligent investigation of disputed claims, verifying eligibility, and preparing appeals based on industry-accepted criteria. They synergize with the Denials team on processes and best practices. Responsibilities include serving as a resource, providing process improvements, and performing medical...

Evaluate and treat all injuries and illnesses of employees in an efficient and professional manner. Manage, guide and direct all referrals to healthcare providers and services. Schedule employees for Pre-Employment Medical Examination, Annual Physical Exam and the executives for their Annual Executive check-up. Assess healthcare needs, implement and manage...

Customer Service Representative for US Healthcare Insurance Company. Answer inbound calls from providers and members on Eligibility and Benefits, Claims Inquiry, and Provider Inquiry pre-authorization. Provide customer service, respond to inquiries, and resolve concerns related to medical and behavioral health, claims, and provider services. Key...