Healthcare Claims Associates
5 days ago
Responsibilities 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 clearing pending claims based on defined policies and procedures Research claims edits to determine appropriate benefit application utilizing established criteria, applies physician contract pricing as needed for entry-level claims Review and address provider inquiries regarding claim adjudication Demonstrate ability to work on high volume of repetitive claims Demonstrate increasing productivity to meet minimum requirements while maintaining quality standards Work Experience At least 2 years experience in medical claims Experience with medical coding to include diagnosis coding and terminology is an advantage but not required Skillset Proficient knowledge on US Healthcare Practice, Medical Coding (ICD-10, CPT4, DRG, HCPCS), Clinical Documentation Improvement, medical terminologies, EDI, and HIPAA protocols Ability to multi-task and follow documented claims processes with minimal supervision Excellent verbal and written business communication skills required Strong proficiency in Windows OS and Microsoft Office applications, particularly Excel Strong attention to detail and the ability to make appropriate decisions based on information presented #J-18808-Ljbffr
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Healthcare Claims Specialist
7 days ago
Taguig, National Capital Region, Philippines Systemantech Full time ₱300,000 per yearThis role is responsible for timely and accurateresolution of account receivables either through insurance payment collections, adjustment, or write offs.This job description will be reviewed periodically and is subject to change by management.RESPONSIBILITIES:➢ Performs AR follow-up on assigned accounts taking into account Timely Filing Limitsset by the...
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Reporting Analyst
2 weeks ago
Taguig, Philippines Tenet Healthcare Full timeReporting Analyst (Healthcare) Tenet Healthcare This position is responsible for the loading and maintenance of Managed Care and other contract pricing terms into various contract management and claim pricing systems of Tenet and USPI entities. The role may also perform complex contract analyses and function as a liaison between claims pricing systems and...
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Healthcare Helpdesk Associates
2 weeks ago
Taguig, Philippines UST Full timeOverview Join or sign in to find your next job. Role: Healthcare Helpdesk Associate at UST. Location: Taguig, National Capital Region, Philippines. Responsibilities Address and resolve inquiries related to patient records, appointment scheduling, billing, insurance claims, and general healthcare services, insurance benefits, provider contracts, eligibility...
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Healthcare Associate
2 weeks ago
Taguig, National Capital Region, Philippines UST Full time ₱25,000 - ₱60,000 per yearThe Customer Service Associate will provide exceptional customer service to customers via inbound Call Center Operations.Duties/Responsibilities:Receive and respond to inbound phone calls for customer assistanceRespond to outbound phone call requestsDocument all calls in ticketing and tracking systemsRespond to customer inquiries and provide data to...
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Healthcare Helpdesk
2 weeks ago
Taguig, National Capital Region, Philippines UST Full time ₱300,000 - ₱450,000 per yearWe are seeking a highly motivated and customer-focused Healthcare Helpdesk Associate to provide frontline support to patients, healthcare professionals, and internal teams. The role involves handling inquiries, troubleshooting issues, and ensuring seamless communication between various stakeholders in a healthcare setting. The associate will be the first...
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Claims Examiner
3 days ago
Taguig, National Capital Region, Philippines Curran Daly + Associates Full time ₱1,200,000 - ₱2,400,000 per yearWe are seeking aPersonal Injury Claims Managerto 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 ideal candidate brings deep expertise in...
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Taguig, Philippines Access Healthcare Services Manila, Inc. Full timeAccess Healthcare is looking for Experienced Medical Billing specialist to be part of our growing team! Responsibilities Work assigned Accounts Receivable accounts or denied claims accounts through the Access Healthcare or client's workflow and follow up on claims with insurance companies Conduct outbound calls to providers to determine if the provider...
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Process Executive in Healthcare Account
2 weeks ago
Taguig, Philippines Metacom Solutions Inc Full timeHealthcare Associate – Job Responsibilities Handle inbound and outbound calls, emails, or chats related to healthcare services. Assist patients, providers, or members with inquiries regarding benefits, claims, eligibility, billing, and medical procedures. Verify patient/member information and update records accurately in the system. Process prior...
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Claims Representative
5 days ago
Taguig, National Capital Region, Philippines Fashion Accessories Shop Miyam Full time ₱900,000 - ₱1,200,000 per yearAbout the roleFashion Accessories Shop Miyam' is seeking a talented Claims Representative (Healthcare Account) to join our team in Taguig City, Metro Manila. This is a full-time, hybrid role, which means you'll have the flexibility to work both in the office and remotely. As a Claims Representative, you'll be an integral part of our customer service team,...
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Taguig, National Capital Region, Philippines Optum, a UnitedHealth Group Company Full time ₱900,000 - ₱1,200,000 per yearThis function is responsible for Collections for Healthcare unpaid claims. The position in this function interact with customers gathering support data to ensure invoice accuracy and also work through specific claims discrepancies. Provide input to policies, systems, methods, and procedures for the effective management and control of the premium collection...