Medical Claims Specialist
3 weeks ago
Medical Claims Specialist (US AR Follow-up/Collections) Optum | Taguig, National Capital Region, Philippines Requirements: Minimum 12 months experience in Healthcare Account Receivable/Collections in a BPO setting. Familiarity with UB Claims and UB04 forms. Experience in medical billing/AR collections. Background in calling insurance (Payer) for claim status and payment disputes. Familiar with EPIC SYSTEM. Willing to work on-site in Quezon City, Taguig and Alabang. Experience in a BPO Healthcare Account is required. Primary Responsibilities Read contracts for payment disputes. Work on the provider side. Verify claim status and collect unpaid claims from insurance. Process claims payments, manage denials, and track claim statuses. Manage collections for healthcare unpaid claims. Interact with customers to ensure invoice accuracy and resolve claims discrepancies. Provide input on policies, systems, methods, and procedures for premium collection management. Educate customers on online applications for claims and payments. Monitor outstanding balances and ensure clients pay as billed. Prepare invoices and reconcile billing with accounts receivables. Conduct quality assurance and audits of collection activities. Handle documents, emails, and calls related to account processes. Perform accounts receivable collections, follow-up, denial management, claims payment processing, tracking, and appeals for hospital processes. Your role is critical in providing confidence in the exceptional care we offer to our members, families, facilities, and health professionals. This is an everyday opportunity to do your life's best work. What We Offer Market Competitive Pay Levels Retirement Plan Medical Plan (HMO) from Day 1 of employment Dental, Medical, and Optical Reimbursements Life and Disability Insurance Sick Leave ConversionTuition Fee Reimbursement Employee Assistance Program (EAP) Annual Performance Based Merit Increases Employee Recognition Training and Staff Development Employee Referral Program Employee Volunteerism Opportunity All Mandatory Statutory Benefits Who We Are Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare. UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone. We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center. As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world. We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines. Elevate your career with a leading health care company while improving lives. Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together Seniority Level Associate Employment Type Full-time Job Function Health Care Provider Industries Business Consulting and Services; Hospitals and Health Care Referrals increase your chances of interviewing at Optum by 2x #J-18808-Ljbffr
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Taguig, Philippines Access Healthcare Services Manila, Inc. Full timeAccess Healthcare is currently looking for Claims Configuration Specialist to be part of our team! The Claims Configuration Specialist is responsible for configuring all aspects of health plan benefit, fee schedule setup, managing our pre-pay edits, analysis, mapping, testing, troubleshooting, and implementation. The ideal candidate will act as a liaison...
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Medical Claims Representative
2 weeks ago
Taguig, National Capital Region, Philippines bde75dff-3139-4d16-a431-77eacc569fbc Full time ₱360,000 per yearJob SummaryThe Healthcare Accounts Receivable (A/R) Specialist is responsible for the timely and accurate resolution of outstanding insurance account balances through payment collection, adjustment, or write-offs. This role ensures the integrity of billing processes and supports the overall revenue cycle through proactive follow-up and problem...
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Claims Specialist
4 weeks ago
Taguig, Philippines Igloo Full timeIgloo is located in Taguig, National Capital Region, Philippines. Claims Specialist 6 days ago – Be among the first 25 applicants. This range is provided by Igloo. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range About Igloo Igloo (formerly Axinan) is the first full-stack insurtech firm...
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Claims Specialist
2 weeks ago
Taguig, National Capital Region, Philippines Igloo Full time ₱1,500,000 - ₱3,000,000 per yearAbout Igloo Igloo (formerly Axinan) is the first full-stack insurtech firm to emerge from Singapore. With offices across Singapore, Indonesia, Thailand, the Philippines, Vietnam, Malaysia, China and India, Igloo is fueled by a mission of making insurance accessible and affordable for all. Igloo's innovation solutions empower companies to eliminate...
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Claims Specialist
2 weeks ago
Taguig, National Capital Region, Philippines Igloo Full time ₱900,000 - ₱1,200,000 per yearAbout IglooIgloo (formerly Axinan) is the first full-stack insurtech firm to emerge from Singapore. With offices across Singapore, Indonesia, Thailand, the Philippines, Vietnam, Malaysia, China and India, Igloo is fueled by a mission of making insurance accessible and affordable for all. Igloo's innovation solutions empower companies to eliminate operational...
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Legal Claims Manager
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Taguig, Philippines Curran Daly + Associates Full timePersonal Injury Claims Manager We are seeking a Personal Injury Claims Manager to lead, strategize, and optimize the firm’s Personal Injury (PI) claims operations across multiple teams. This role plays a critical part in driving case efficiency, ensuring compliance with U.S. PI standards, and enhancing overall client experience and claim outcomes. The...
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Bilingual Claims Operations Specialist
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Taguig, National Capital Region, Philippines Saperium Full time ₱400,000 - ₱600,000 per yearBilingual Claims Operations Specialist (French - English)Job OverviewOPENLANE is looking for an Claims Operations Specialist who will be mainly liaising calls to ensure only customers with existing arbitration cases are transferred to the Arbitration team. The position requires the management of timely arbitration between buyers and sellers with the goal of...
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Healthcare Claims Associates
4 weeks ago
Taguig, Philippines UST Full timeResponsibilities Responsible for the accurate processing and completion of medical claims based defined claims guidelines and policies Process new claims or modifies existing claims according to the appropriate and applicable action Analyze claims to determine appropriate action to approve or deny a claim for payment Determine accurate payment criteria for...
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PHRN - Medical Coding Manager
2 weeks ago
Taguig, Philippines Carelon Global Solutions Full timeJob Profile Summary Responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. Primary duties may include, but are not limited to: Analyzes and audits claims by integrating medical chart coding principles,...
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PHRN - Medical Coding Manager
2 weeks ago
Taguig, National Capital Region, Philippines b707e90b-bfaa-4036-9cae-f80dbd385947 Full time $60,000 - $120,000 per yearJob Description:Responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims.Primary duties may include, but are not limited to:Analyzes and audits claims by integrating medical chart coding principles, clinical...
