Medical Insurance Claims Specialist

1 day ago


Mandaue City, Central Visayas, Philippines beBeeInsurance Full time $40,000 - $55,000
About This Role

We're seeking a highly skilled Medical Insurance Claims Analyst to join our dynamic team in this exciting opportunity.

Key Responsibilities:
  • Maximize Insurance Reimbursement: Work closely with healthcare practice owners to ensure timely and accurate insurance reimbursement.
  • Root Cause Analysis: Identify and resolve issues related to medical insurance claim denials, underpayments, or delays.
  • Insurance Carrier Interaction: Communicate effectively with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment.
  • Denial Appeal Process: Plan and execute medical insurance claim denial appeal process.
  • Data Verification: Collaborate with US-based practice owners and clinicians to complete and correct missing or incorrect data on their insurance claims.
Requirements:
  • Minimum 6 months experience in US-based AR follow-up and charge/payment posting.
  • Familiarity with US medical insurance industry and insurance claims processing cycle.
  • Knowledge of ICD-10, CPT, and HCPC coding systems.
  • Understanding of CMS-1500 and UB-04 claim formats.
  • Experience with Vericle Software required.
  • Excellent listening, communication, and problem-solving skills.
  • Self-motivated and able to work independently.
Key Skills and Qualifications:
  • Strong analytical and problem-solving skills.
  • Excellent communication and interpersonal skills.
  • Able to work in a fast-paced environment.
  • High level of accuracy and attention to detail.

This is an entry-level position suitable for individuals looking to start their career in revenue cycle management. If you're passionate about working in a dynamic environment and are eager to learn, we encourage you to apply.



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