Medical Claims Specialist

3 weeks ago


Pasig, National Capital Region, Philippines Visaya KPO Full time
Job Responsibilities:
  • Claim Verification: Utilize various hospital and physician systems to ensure patient, billing, and claim information accuracy.
  • Billing Compliance: Perform primary, secondary, and tertiary billing functions, including electronic, paper, and portal submission to government and commercial payers.
  • Claim Editing: Edit claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission.
  • Communication: Respond to emails and telephone messages in a timely manner and communicate issues to management.
  • Professional Development: Participate in meetings, training seminars, and adhere to professional standards, hospital policies, and procedures.

Additional Responsibilities:

  • Provider Billing Manuals: Utilize provider billing manuals to obtain billing guidelines and requirements.
  • Import/Export Files: Import verification and escalation of import/export files.
  • Special Handling Billing: Handle interim bills, overlap review, redistribution of money for correct claim creation, and resolve billing rejections.


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time

    Job SummaryWe are seeking a highly skilled Medical Claims Specialist to join our team at Visaya Knowledge Process Outsourcing. As a key member of our healthcare accounts receivable team, you will be responsible for verifying patient eligibility, obtaining authorizations, and resolving claims denials.Key ResponsibilitiesVerify patient eligibility and obtain...


  • Pasig, National Capital Region, Philippines Visaya KPO Full time

    Job DescriptionThe Medical Insurance Accounts Receivable Representative is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables.Key Responsibilities:Verify patient eligibility and/or authorization for healthcare services performed by searching payer web sites or client eligibility systems, or...


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Corp Full time

    Job Summary:We are seeking an experienced AR Team Lead to join our team at Visaya Knowledge Process Outsourcing Corp. The successful candidate will be responsible for leading our medical claims team and ensuring timely and accurate claims processing.Key Responsibilities:• Verify patient eligibility and obtain necessary authorizations• Update patient...


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time

    Are you a detail-oriented professional with experience in medical collections and denials? We are seeking a Medical Claims Analyst to join our team at Visaya Knowledge Process Outsourcing in Ortigas, Pasig City. About the RoleWe are looking for an experienced Medical Claims Analyst to work onsite in Ortigas, Pasig City. As a Medical Claims Analyst, you will...


  • Pasig, National Capital Region, Philippines Visaya KPO Full time

    Job Title: Medical Insurance Recovery RepresentativeThe Medical Insurance Recovery Representative at Visaya KPO plays a crucial role in the timely collection of outstanding government or commercial healthcare insurance receivables.Responsibilities:Verify patient eligibility and/or authorization for healthcare services by searching payer web sites or client...


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Corp Full time

    Job Title: Medical Collections Team LeadAt Visaya Knowledge Process Outsourcing Corp, we are seeking a highly skilled Medical Collections Team Lead to join our team. As a key member of our revenue cycle management team, you will be responsible for leading a team of medical collections specialists in resolving complex insurance claims and ensuring timely...


  • Pasig, National Capital Region, Philippines Visaya KPO Full time

    Job OverviewWe are seeking an experienced Clinical Denials Specialist to join our team at Visaya KPO. The successful candidate will be responsible for managing medical collections and denials, ensuring timely payments and resolving claims efficiently.About the RoleThis is a full-time position based in Ortigas, Pasig City, with opportunities for career growth...


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Corp Full time

    Job Title: Medical Collections Team LeadJob SummaryWe are seeking a highly skilled Medical Collections Team Lead to join our team at Visaya Knowledge Process Outsourcing Corp. The ideal candidate will have a strong background in medical billing and collections, with experience in team leadership and management.Key ResponsibilitiesLead a team of medical...


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time

    Main ResponsibilitiesWe are seeking a highly skilled Insurance Claims Review Specialist to join our team at Visaya Knowledge Process Outsourcing. The ideal candidate will have a strong background in health care finance and experience in reviewing insurance claims.Review insurance claims and identify overpayments and credit balances.Evaluate and verify...


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time

    Job DescriptionThe Medical Cash Posting Specialist is a vital role in our team at Visaya Knowledge Process Outsourcing. This position involves performing various tasks related to cash remittance, insurance claims, and billing systems.Key Responsibilities:Process daily lockbox images and bank statements accurately and efficiently.Review insurance explanations...


  • Pasig, National Capital Region, Philippines Visaya KPO Full time

    Job Title: AR Complex Clinical Denials SpecialistAt Visaya KPO, we are seeking a highly skilled and experienced AR Complex Clinical Denials Specialist to join our team.Key Responsibilities:Verify and obtain eligibility and/or authorization using payer websites, client eligibility systems, or via phone with insurance carriers/providers.Update patient...

  • AR Specialist

    3 weeks ago


    Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time

    Job Title: AR Specialist - Healthcare AccountAbout the Role:We are seeking a skilled AR Specialist - Healthcare Account to join our team at Visaya Knowledge Process Outsourcing. As an AR Specialist - Healthcare Account, you will be responsible for verifying eligibility and authorizing medical claims, updating patient demographics and insurance information,...


  • Pasig, National Capital Region, Philippines Recruiter PH Full time

    We are seeking a Medical Allied Associate to join our team at Recruiter PH. With the right qualifications and experience, this role offers a competitive salary package of PHP 30,000 - 40,000 per month.Job SummaryThis position is ideal for graduates of medical, allied health, and life science courses who have prior authorization experience from a local or...


  • Pasig, National Capital Region, Philippines Med-Metrix International Full time

    Job DescriptionAt Med-Metrix International, we are seeking a skilled Medical Coding Specialist to join our team. In this role, you will be responsible for conducting audits and coding reviews to ensure accurate documentation.Key Responsibilities:Conduct audits and coding reviews to verify accuracy of documentation, including partnerships with external...


  • Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Full time

    Job DescriptionAt Visaya Knowledge Process Outsourcing, we are seeking a highly skilled Financial Claims Specialist to join our team. As a key member of our revenue cycle department, you will play a crucial role in ensuring the accuracy and efficiency of insurance refunds.**Key Responsibilities:**Reviewing and analyzing refund and overpayment requests from...


  • Pasig, National Capital Region, Philippines MetaHealth Full time

    Job Title: Medical Supply Chain SpecialistWe are seeking a highly skilled Medical Supply Chain Specialist to join our team at MetaHealth. The ideal candidate will have a strong understanding of the regulatory environment and knowledge of pharmaceutical and medical devices distributors.Main Responsibilities:* Strong understanding of the regulatory...


  • Pasig, National Capital Region, Philippines Gratitude Philippines Full time

    Job OverviewWe are seeking highly motivated and empathetic Medical Support Specialists to join our team at Gratitude Philippines. As a key member of our support team, you will be responsible for providing exceptional customer service and support to clients.Estimated SalaryThe total package for this role is PHP 17,000 per month, making it an attractive...


  • Pasig, National Capital Region, Philippines Visaya KPO Full time

    Job Title:AR Complex Clinical Denials SpecialistJob Description:Role Summary: We are seeking a highly skilled Clinical Denials and Appeals Specialist to join our team at Visaya KPO. As a key member of our Accounts Receivable department, you will be responsible for researching and resolving complex clinical denials, ensuring timely payments and maintaining...


  • Pasig, National Capital Region, Philippines Visaya KPO Full time

    Billing Specialist RoleAt Visaya KPO, we are seeking a skilled Billing Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely billing and claims processing for our clients.Key Responsibilities:Verify patient, billing, and claim information for accuracy using various hospital and...


  • Pasig, National Capital Region, Philippines Global Rescue Full time

    Medical Operations Specialist Job DescriptionAt Global Rescue, our mission is to provide exceptional medical care and support services to our members in critical situations.About the Role:We are seeking an experienced Medical Operations Specialist to join our team. In this role, you will be responsible for staffing emergency access telephone lines in our...