Medical Insurance Claim Resolution Specialist

24 hours ago


Makati City, National Capital Region, Philippines beBeeReimbursement Full time ₱350,000 - ₱500,000
Job Overview

ClinicMind is seeking a skilled Medical Biller AR Follow-up Analyst to maximize insurance reimbursement for healthcare practice owners. This role involves identifying the root causes of medical insurance claim denials, underpayments, or delays and proposing resolutions.

Key Responsibilities:
  • Optimize insurance reimbursement for healthcare practice owners
  • Discover root causes for medical insurance claim denial, underpayment, or delay and propose effective solutions
  • Interact with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment issues
  • Develop and execute a plan to appeal denied medical insurance claims
  • Collaborate with US-based practice owners and clinicians to ensure accurate and complete data on their insurance claims
Required Skills and Qualifications:
  • Minimum of 6 months experience in US-based AR follow-up and charge and payment posting
  • Familiarity with the 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 working with Vericle Software is a must
  • Excellent listening, communication, and problem-solving skills
  • Ability to work independently and be self-motivated
Working Requirements:
  • High comfort level working on Eastern Time Zone/US Shift
  • Reliable access to high-speed internet at home
  • Mobile Hotspot availability
  • Minimum laptop/Desktop with 8 GB RAM


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