Medical Claims Specialist

1 day ago


Mandaue City, Central Visayas, Philippines beBeeMedicine Full time $50,300 - $70,300
Job Summary

We are seeking a skilled Medical Claims Specialist to perform end-to-end revenue cycle processes. The ideal candidate will be responsible for monitoring medical claims, investigating rejections and denials, and documenting related account activities.

Key Responsibilities
  • Verify patient eligibility and benefits for accurate coverage
  • Review and submit claims in a timely and compliant manner
  • Obtain prior authorizations for smooth claim approvals
  • Monitor claim status and conduct follow-up to ensure prompt payment
  • Research and resolve claim rejections and denials
  • Generate and submit patient statements without patient interaction
  • Document all account activities accurately and on time
  • Post manual payments, apply adjustments, and manage collections from various payers
Requirements
  • At least 2 years of experience in end-to-end revenue cycle processes
  • Strong understanding of Medicare, Medicaid, and commercial insurance eligibility requirements and payment methodologies
  • Ability to work collaboratively with team members and healthcare providers
  • Excellent customer service skills
Benefits

This position offers an opportunity to develop skills in medical billing and contribute to the organization's financial success.



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