Medical Billing Claims Specialist

5 days ago

Ayala Alabang, National Capital Region, Philippines WHR Global Consulting Full time
Overview

POSITION TITLE: Medical Billing and Insurance Claims Specialist

WORK LOCATION: Alabang, Muntinlupa

WORK SETUP: Onsite

WORK SCHEDULE: Night Shift

Qualifications
  • Minimum of 1 year of experience in medical billing, insurance claims, or a related field
  • Must have at least 6 months of BPO experience handling healthcare accounts
  • Strong English proficiency, both verbal and written
  • Familiarity with healthcare regulations and industry guidelines
  • Excellent communication skills with the ability to make outbound calls to insurance companies and payors
  • Detail-oriented and able to maintain accurate records
  • Ability to work independently while adhering to internal guidelines and procedures
  • Proficiency in Microsoft Office Suite or similar software; experience with medical billing software is a plus
  • Willing to start ASAP
Responsibilities
  • Make outbound calls to insurance companies and payors to collect essential information, including claim statuses, denial reasons, and any additional relevant details
  • Conduct all calls in full compliance with the client's guidelines and applicable healthcare regulations
  • Maintain professionalism and ensure clear communication during each call
  • Accurately record, categorize, and label calls or information gathered using the taxonomy and definitions provided by the client
  • Ensure all claim statuses and call outcomes are properly labeled for consistency in reporting and easy analysis
  • Deliver categorized data in periodic reports or through the client's portal, following the requested format and frequency
  • Analyze recorded call transcripts to extract actionable insights, identifying trends, recurring denial reasons, and other patterns
  • Compile findings into periodic reports, providing valuable information to support process improvements and optimize workflows
Details
  • Seniority level: Entry level
  • Employment type: Full-time
  • Job function: Health Care Provider
  • Industries: Human Resources Services
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