Medical Claims Analyst

3 weeks ago


Philippines Manila Med-Metrix Full time
Job Type

Full-time

Description

  • 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.

Requirements

  • 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 night shifts.
  • Willing to work onsite in Pasig City


  • Manila, Philippines Med-Metrix Full time

    Job TypeFull-timeDescriptionFollow-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...


  • Metro Manila / NCR, Philippines Microsourcing Philippines Inc Full time

    With over 7,000 professionals across 9 delivery centers in the Philippines, MicroSourcing remains the country's largest offshoring solutions provider. Medical Claims Analyst, be 100% YOU with MicroSourcing! A Medical Claims Analyst is expected to: Claim DenialsSubmit appeals as neededSubmit corrected claims as neededCall Insurances to inquire about denied...


  • Quezon City, Philippines Nezda Technologies, Inc. Full time

    Nezda Technologies Inc. is hiring Medical Claims Adjudicator (Mandarin). Salary: P32,000 - P45,000 Target Start Date: ASAP!Qualifications: Medical course is preferred but not required. Basic to intermediate proficiency in Chinese language (verbal and written). No Experience Required.Work Setup: Hybrid. Dayshift. Weekends Off.


  • Manila, Philippines Med Supply US Full time ₱30,000 - ₱35,000

    Med Supply US is one of the nation's leading home medical supply companies with years of experience serving patients with complex medical needs. We offer a full scope of Continuous Glucose Monitors (CGMs) and other diabetes products and services. We have built a collaborative culture that has allowed us to hire the best and deliver a world-class...


  • Philippines Vector Outsourcing Solutions Philippines Full time

    Job Description:Provide Medical Practice Analysis for new and potential clients and/or existing clients.Work with Analytics team and Report writers who will prepare Historical data reports, AR reports, denial reports and other Financial reports needed for the practice analysis.Review the report's data for accuracy and consistency; check if other reports are...


  • Philippines Clark Outsourcing Full time

    Salary: 35,000 PHP a monthOversee the processing and exchange of claims and payments with third-party insurance carriers, including addressing related correspondenceIdentify and acquire missing explanation of benefits, ensuring proper posting to aging accountsTake active measures to reduce overall aging of accountsMonitor and verify accurate claims payments...

  • Medical Case Manager

    3 weeks ago


    Taguig, Philippines Gratitude Philippines Full time

    Roles And Responsibilities PH Registered nurses to review workers compensation claims with serious injury and that need surgery/lengthy treatments, create a return-to-work plan, work with various stakeholders (medical providers, injured worker, employer, attorney) to track the treatment plan and help bring the injured worker back to work. Nurses have...

  • AR Medical Biller

    3 weeks ago


    Metro Manila / NCR, Philippines Microsourcing Philippines Inc Full time

    Job Description:Analysis- Understand billing/coding as it relates to allergy care- Understand basic codes used in medical allergy billing- Detect trends in rejections- Review insurance contracts- Relay changes in payment fee schedule to M.D.Medical records- Coordinate with on site office manager promptly re appeals that are needed, medical record requests...


  • Taguig, Philippines Polytechnic University of the Philippines Full time

    Description:Duties and Responsibilities:Assists in new matters, endorsements, finalizing medical updates and release of documentsAssists in settlements and repatriation of seafarers/human remains when the Liaison Officer is not availableAdheres to the Quality Policy, Quality Objectives and the requirements of ISO 9001Qualifications:College degree holderGood...

  • Nursing Graduate

    2 weeks ago


    Philippines, Central Visayas OPON MEDICAL DIAGNOSTIC CORP Full time

    Excellent communication skills. Receive and assist patients as needed Type medical documents (e.g. physician dictations and patient charts) Maintain detailed patient and medical records Manage office communications (e.g. phone, correspondence) Schedule medical appointments Work with insurance companies to process claims Ensure confidentiality of sensitive...

  • Data Analyst

    4 days ago


    Philippines Theoria Medical Full time

    INSERT JOB DESCRIPTION-------Data Analyst Company Overview: Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care. Theoria serves facilities across the United States with a multitude of services to improve the quality of care...

  • Medical Biller

    2 weeks ago


    Philippines, Quezon City Neolytix Full time

    Job DescriptionAbout NeolytixNeolytix is a boutique Consulting and Management Services Organization that works with small & medium-sized healthcare providers across the United States. Our portfolio of services caters to micro verticals and is built on the expertise we have developed in enabling these practices.Working at NeolytixAt Neolytix, you will learn...


  • Philippines Phoenix Virtual Solutions Full time

    Job DescriptionThe Medical Biller is responsible for a broad range of billing functions byproviding operational support through the full billing cycle: duties include accounts reviews/billing, payment posting,billing, claim submissions, medical insurance communications, and other billing matters. In this role, theThe specialist is responsible for working,...


  • Philippines, Quezon City MicroSourcing Full time

    Job Responsibilities:. Process and submit insurance claims in accordance with insurer requirementsand federal regulations.. Handle billing and invoicing for therapists utilizing our EMR platform, ensuringaccuracy and compliance with healthcare regulations.. Conduct regular follow-ups on unpaid claims with insurers and other third parties,and manage denials...

  • Registered Nurse

    3 weeks ago


    Philippines, Manila Metacom Careers Full time

    ResponsibilitiesConducts utilization reviews to determine if patients are receiving care appropriate to illness or condition.Consults with medical and treatment staff regarding client diagNosis, medical justification, length of treatment, and case documentation.Communicate with physicians to ascertain their plans for a timely discharge.Handle inbound and...

  • Nurse Medical Mgmt I

    4 weeks ago


    Philippines Carelon Global Solutions Full time

    Description: Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and...

  • Registered Nurse

    4 weeks ago


    Manila, Philippines Metacom Careers Full time

    ResponsibilitiesConducts utilization reviews to determine if patients are receiving care appropriate to illness or condition.Consults with medical and treatment staff regarding client diagNosis, medical justification, length of treatment, and case documentation.Communicate with physicians to ascertain their plans for a timely discharge.Handle inbound and...

  • Medical Coder

    3 weeks ago


    Philippines, Pasig City MicroSourcing Full time

    With more than 8,000 professionals across 9 delivery centers in the Philippines, MicroSourcing remains the country's largest provider of offshoring solutions.Medical Coder, Be 100% YOU with MicroSourcing!Duties and Responsibilities:Assist in medical claims validation, billing denials, and appeals process.Apply remittances consisting of deposits, credit...


  • Philippines Aspire Global Solutions Full time

    Administered daily billing functions, which included medical coding, charge entry, claims, payment postings, and reimbursement management. Accurately input of codes onto in house billing database for generating invoices Utilized electronic filing system to submit claims in a timely manner Reviewed and validated accuracy of charges, including dates of...


  • Manila, Philippines ACCPRO INTERNATIONAL Full time

    We're looking for: Finance Analyst-General Accounting Job Description • Review and enter supplier invoices and employee expense claims into NetSuite using correct accounting entries with applicable taxes such as withholding taxes, VAT, or GST • Ensures that accounting entries from accounts payable and payment advice are checked for validity, mathematical...