Senior Medical Claims Specialist

1 day ago


Pulong Santa Cruz, Calabarzon, Philippines beBeeClaims Full time ₱40,000 - ₱70,000
Medical Claims Processor

As a Medical Claims Processor at a leading healthcare organization, you will be responsible for managing the entire claims processing cycle from submission to payment.

Key Responsibilities:
  • Coordinate with various departments to gather necessary information and post charges to patient accounts.
  • Review claims for accuracy, completeness, and consistency before submitting them to payers.
  • Prepare and issue accurate billing statements to the correct payer using electronic systems.
  • Monitor all submissions daily to address any denials or requests for additional information.
  • Follow up on unpaid claims/denials within standard timeframes; determine reasons for denial and correct claims as needed.
  • Document all communications and collection attempts in accordance with established policies and procedures.
  • Provide necessary supporting documentation to payers upon request in a timely manner.
  • Maintain accurate records of A/R Aging levels for assigned accounts.
Requirements:
  • Two to three years of experience processing skilled nursing medical claims with third-party payers including Medicare, Managed Care, and Insurance Companies with a proven track record of successful collections.
  • One or more years of experience working in a high-volume, short-term rehab environment.
  • Familiarity with billing software and proficiency in Microsoft Office.
  • Ability to learn and adapt to new IT systems quickly.
Benefits:

You will have the opportunity to work in a fast-paced, dynamic environment and contribute to the success of our organization. If you are a detail-oriented, organized individual with excellent communication skills, we encourage you to apply.



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