Medical Claims Analyst

1 day ago


Angeles City, Central Luzon, Philippines beBeeInsurance Full time ₱30,000 - ₱50,000

ClinicMind, a leading Electronic Healthcare Records (EHR) software and Revenue Cycle Management (RCM) services provider, is seeking a Medical Claims Analyst. If you're passionate about maximizing insurance reimbursement for healthcare practice owners, this could be the perfect opportunity.

Responsibilities
  1. Maximize insurance reimbursement for healthcare practice owners by analyzing claims data and identifying areas of improvement.
  2. Investigate root causes of medical insurance claim denials, underpayments, or delays and propose effective resolutions.
  3. Communicate with insurance carriers to follow up on unpaid claims, delayed processing, and underpayment.
  4. Develop and implement medical insurance claim denial appeal processes.
  5. Collaborate with practice owners and clinicians to complete and correct missing or incorrect data on insurance claims.
Qualifications
  1. Minimum 6 months experience in US-based AR follow-up and charge/payout processing.
  2. College degree in Computer Engineering, Mathematics, or similar field.
  3. Hands-on experience with data analysis and classification.
  4. Strong analytical skills.
  5. Familiarity with the US medical insurance industry and claims processing cycle.
  6. Knowledge of ICD-10, CPT, and HCPC coding systems.
  7. Understanding of CMS-1500 and UB-04 claim formats.
  8. Experience with Vericle Software is an advantage.
  9. Excellent listening, communication, and problem-solving skills.
  10. Ability to work autonomously and self-motivated.
  11. Experience in chiropractic, physical therapy, and mental/behavioral health specialties.
Must-Haves
  1. High comfort level working Eastern Time Zone/US shift.
  2. Good internet access at home.
  3. Mobile Hotspot.
  4. Laptop/Desktop with at least 8 GB RAM.


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