Healthcare Claims Specialist
2 days ago
the accounts assigned to them.
Job Responsibilities:
• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites.
• Meets and maintains daily productivity/quality standards established in departmental policies.
• Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts.
• Adheres to the policies and procedures established for the client/team.
• Knowledge of timely filing deadlines for each designated payer.
• Performs research regarding payer specific billing guidelines as needed.
• Ability to analyze, identify and resolve issues causing payer payment delays.
• Ability to analyze, identify and trend claims issues to proactively reduce denials.
• Communicates to management any issues and/or trends identified.
• Initiate appeals when necessary.
• Ability to identify and correct medical billing errors.
• Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process.
• Understanding of under or over payments and credit balance processes.
• Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required.
• Act cooperatively and courteously with patients, visitors, co-workers, management and clients.
• Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Work independently from assigned work queues.
• Maintain confidentiality at all times.
• Maintain a professional attitude.
• Other duties as assigned by the management team
Job Qualifications:
• Completed at least High School education
• With minimum 1 year of Healthcare Account Receivable/Collections in a BPO setting or environment (claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers)
• Experienced on medical billing/ AR Collections.
• Background in calling insurance (Payer) to verify claim status and payment dispute.
• Must be amenable to work onsite and night shifts.
-
Medical Claims Specialist
3 days ago
Pasig, National Capital Region, Philippines Manpower Core Group Inc. Full timeCompany OverviewManpower Core Group Inc. is a leading provider of workforce solutions, committed to delivering exceptional service and results-driven outcomes. Job DescriptionWe are seeking a highly skilled Medical Claims Specialist to join our team. As a key member of our clinical support team, you will play a critical role in ensuring the smooth operation...
-
Healthcare Claims Analyst
22 hours ago
Pasig, National Capital Region, Philippines Med-Metrix, LLC Full timeAbout Med-Metrix, LLCWe are a leading provider of healthcare services, dedicated to delivering high-quality care to our patients. Our team is passionate about making a difference in the lives of others, and we are seeking like-minded individuals to join us.The Insurance Information Coordinator will play a vital role in supporting our Collections and/or...
-
Medical Claims Specialist
16 hours ago
Pasig, National Capital Region, Philippines Eastvantage Full timeAbout the RoleWe are seeking a highly skilled Medical Claims Specialist to join our team at Eastvantage. In this role, you will play a crucial part in resolving overdue payments and ensuring accurate billing processes within our healthcare organization.
-
Healthcare Revenue Specialist
14 hours ago
Pasig, National Capital Region, Philippines Eastvantage Full timeAbout the RoleWe are seeking a highly skilled Healthcare Revenue Specialist to join our Eastvantage team. As a key member of our billing operations department, this role will be responsible for ensuring the accurate and timely submission of claims to payers, maintaining compliance with industry standards, and maximizing clean claim...
-
Claims Officer
1 week ago
Pasig, National Capital Region, Philippines Hive Health Full timeReady to make an impact? At Hive Health and HPPI, a subsidiary of Hive Health, we're on a mission to make healthcare radically more accessible for all—and we need passionate, driven individuals to help us make it happen. If you thrive in a fast-paced, innovative environment and want to work on solutions that truly matter, we'd love to meet youHi We're...
-
Healthcare Claims Professional
3 days ago
Pasig, National Capital Region, Philippines Vector Outsourcing Solutions Philippines Full timeAbout the RoleWe are looking for a highly motivated and organized Medical Billing Consultant to join our team at Vector Outsourcing Solutions Philippines.The successful candidate will have excellent communication skills, both written and verbal, and be able to work with confidential information.Key Responsibilities:Claims Creation: Ensure the preparation of...
-
Healthcare Call Center Specialist
4 days ago
Pasig, National Capital Region, Philippines Med-Metrix, LLC Full timeAbout the RoleWe are seeking a highly skilled Healthcare Call Center Specialist to join our team at MED-METRIX, LLC. As a key member of our customer service team, you will be responsible for providing exceptional patient care and resolving complex issues related to medical claims processing.Job SummaryProvide professional and courteous service to patients...
-
Medical Claims Specialist
1 week ago
Pasig, National Capital Region, Philippines Risewave Consulting Inc. Full timeYou will be responsible for collections, account follow up, billing and allowance posting for the accounts assigned.Duties and Responsibilities:• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites.• Meets and maintains daily productivity/quality standards established in departmental...
-
Healthcare Operations Coordinator
6 days ago
Pasig, National Capital Region, Philippines Manpower Core Group Inc. Full timeCareer OpportunityWe are looking for a highly skilled Healthcare Operations Coordinator to join our team at Manpower Core Group Inc. As a Healthcare Operations Coordinator, you will be responsible for managing the day-to-day operations of our healthcare services, including determining customer eligibility, assessing medical appropriateness of claims, and...
-
Medical Claims Adjuster
6 days ago
Pasig, National Capital Region, Philippines Manpower Core Group Inc. Full timeJob DescriptionWe are seeking an experienced Medical Claims Adjuster to join our team at Manpower Core Group Inc. As a Medical Claims Adjuster, you will be responsible for providing critical support to our clinical team and clients by determining customer eligibility, assessing medical appropriateness of claims, and ensuring accurate and timely payment of...
-
Medical Claims Analyst
2 weeks ago
Pasig, National Capital Region, Philippines Lennor Group Full timeAbout Lennor GroupAs 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,...
-
Claims Resolution Expert
2 days ago
Pasig, National Capital Region, Philippines Risewave Consulting Inc. Full timeJob Overview:Risewave Consulting Inc. has an exciting opportunity for a highly motivated Claims Resolution Expert to join our team. As a Claims Resolution Expert, you will be responsible for resolving outstanding claims and ensuring that our clients receive timely payment.Key Responsibilities:• Analyze and resolve issues causing payer payment delays;•...
-
Medical Claims Expert
15 hours ago
Pasig, National Capital Region, Philippines Eastvantage Full timeJob OverviewThe Eastvantage team is seeking a skilled Medical Claims Expert to join our billing operations department. This role plays a vital part in ensuring the accurate and timely submission of claims to payers, maintaining compliance with industry standards, and maximizing clean claim rates.Key Responsibilities:Claim Preparation and Submission: Prepare...
-
Healthcare Documentation Specialist
7 days ago
Pasig, National Capital Region, Philippines Manpower Core Group Inc. Full timeAbout This Role:The Medical Records Assistant is responsible for supporting the Medical Records Coordinator in ensuring the smooth flow of medical information between healthcare providers and patients.This position requires the ability to safeguard patient data by implementing effective security measures to prevent unauthorized access or tampering.In this...
-
Healthcare Billing Specialist
15 hours ago
Pasig, National Capital Region, Philippines Eastvantage Full timeJob Summary:The Billing Specialist is responsible for ensuring the accurate and timely submission of claims to payers, maintaining compliance with industry standards, and ensuring billing accuracy. This role focuses on precise claim preparation, attention to detail, and proper documentation to minimize errors and maximize clean claim rates. The ideal...
-
Medical Claims Analyst
1 hour ago
Pasig, National Capital Region, Philippines Med-Metrix Full timeJob DescriptionPosted Thursday, February 13, 2025 at 4:00 PMJoin our dynamic team and make a meaningful impact in the healthcare industry. As a Medical Claims Analyst, you'll play a pivotal role in ensuring accurate claims processing while advancing your career in a supportive and innovative environment. Enjoy competitive benefits upon hire, ongoing...
-
Clinical Support Specialist
6 days ago
Pasig, National Capital Region, Philippines Manpower Core Group Inc. Full timeJob OverviewAt Manpower Core Group Inc., we offer a challenging opportunity for an experienced professional to join our medical claims team. We are seeking a highly skilled Clinical Support Specialist to provide critical support to our clinical team and clients. The successful candidate will be responsible for determining customer eligibility, assessing...
-
Medical Billing Specialist
2 days ago
Pasig, National Capital Region, Philippines Risewave Consulting Inc. Full timeJob Description:Risewave Consulting Inc. is seeking a skilled Medical Billing Specialist to join our team. As a Medical Billing Specialist, you will play a crucial role in ensuring timely resolution of outstanding claims and maintaining daily productivity standards.Key Responsibilities:• Follow up with payers to ensure timely resolution of all outstanding...
-
Specialist Healthcare
17 hours ago
Pasig, National Capital Region, Philippines Metacom Full timeJob OverviewWe are seeking a skilled Healthcare Specialist to join our team at Metacom. In this role, you will play a crucial part in improving customer retention by providing tailored solutions and services that meet the evolving needs of our clients.Main Responsibilities:Client Engagement: Establish strong relationships with clients through regular...
-
Medical Adjudication Specialist
1 week ago
Pasig, National Capital Region, Philippines Hive Health Full timeReady to make an impact? At Hive Health and HPPI, a subsidiary of Hive Health, we're on a mission to make healthcare radically more accessible for all—and we need passionate, driven individuals to help us make it happen. If you thrive in a fast-paced, innovative environment and want to work on solutions that truly matter, we'd love to meet youHi We're...