Medical Claims Analyst

2 weeks ago


Pasig, National Capital Region, Philippines Lennor Group Full time

About Lennor Group

As a proud Filipino company, we are committed to providing world-class business and workforce solutions. Our deep market expertise, combined with a global perspective, empowers us to serve businesses of all sizes and industries efficiently.

Our brand, Lennor Metier, is a leading recruitment agency and headhunting firm in the Philippines, partnering with reputable companies to source top talent for direct-hire opportunities. It specializes in IT, Finance, Engineering, Sales & Marketing, Supply Chain, HR, and Executive Search.

Start Date: March 10, 2025
Industry: Healthcare
Salary Range: ₱35,000 Package
Work Setup: Onsite
Work Schedule: Night Shift
Location: Ortigas

Job Overview

We are looking for a Medical Claims Analyst to manage claim processing, billing, collections, and account reconciliation. This role involves ensuring timely resolution of outstanding claims, identifying billing discrepancies, and maintaining compliance with healthcare regulations. You will work closely with payers, clients, and internal teams to drive efficiency and accuracy in claim management.

Your Responsibilities:

Claims Processing & Resolution

  1. Follow up on outstanding claims via phone, email, or online portals.
  2. Analyze and resolve claim discrepancies to prevent payment delays.
  3. Identify and correct medical billing errors.
  4. Process appeals with proper documentation and communication.

Billing & Account Management

  1. Maintain accurate records of underpayments, overpayments, and credit balances.
  2. Conduct research on payer-specific billing guidelines and policies.
  3. Adhere to timely filing deadlines and compliance standards.

Reporting & Compliance

  1. Track and report claim trends to minimize denials.
  2. Ensure compliance with HIPAA and data protection regulations.
  3. Maintain confidentiality and professionalism in all interactions.

Collaboration & Special Projects

  1. Work independently while coordinating with internal teams on claim resolutions.
  2. Provide support on special Accounts Receivable (A/R) projects as needed.
  3. Act courteously and professionally with patients, providers, and stakeholders.

What our Client is Looking For:

  1. Education: At least a high school graduate.
  2. Experience: Minimum 1 year of US Insurance Follow-Up (outbound) experience.
    1. Strong understanding of claims processing for providers (physicians and/or hospitals).
    2. Ability to explain EOBs, claims, and denials effectively.
  3. Communication: Above-average English communication skills.
  4. Work Setup: Must be willing to work onsite in Ortigas, Pasig.
  5. Schedule: US shift (9 PM – 5 AM) with fixed weekends off.

Ready to take the next step in your career? Submit your application now

We kindly request your patience as we receive a significant number of applications. Rest assured that our team will update your application's status soon. In the meantime, we encourage you to follow our LinkedIn page to stay informed about future opportunities and company updates.

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