Medical Claims Specialist

1 day ago


Cebu City, Central Visayas, Philippines beBeeClaims Full time ₱400,000 - ₱800,000

Job Summary:

  • We are seeking a highly skilled Medical Claims Specialist to join our team.

About the Role:

  1. This is a unique opportunity for a detail-oriented professional to utilize their analytical skills in insurance verifications, claim coding and submission.

Key Responsibilities:

  1. Verify insurance details for patients online and via phone calls to ensure timely and accurate processing of claims.
  2. Code claims according to each insurer's requirements, adhering to specific guidelines and regulations.
  3. Review and scrub claims for potential denials, taking corrective action within specified timeframes.
  4. Submit claims through our claims management system within the required timeframe.
  5. Correct and resubmit denied claims in a timely manner, ensuring minimal disruption to patient care.
  6. Pull reports from insurer websites, post payments, and prepare monthly payment reports for review and analysis.
  7. Maintain current credentialing for each insurer, ensuring compliance with industry standards.

Required Skills and Qualifications:

  1. Attention to detail and analytical skills to ensure accuracy in claim processing.
  2. Excellent communication skills to effectively interact with patients, insurers, and internal stakeholders.
  3. Ability to learn and adapt to new software systems, including our claims management platform.
  4. Multi-tasking capabilities to manage multiple claims simultaneously and meet deadlines.

Benefits:

  • A competitive salary and benefits package.
  • Ongoing training and development opportunities to enhance your skills and knowledge.
  • A dynamic and supportive work environment that encourages growth and collaboration.

Others:

  • A chance to make a real difference in the lives of our patients and their families.
  • An opportunity to work with a talented and dedicated team of professionals.


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