Detailed Medical Claims Analyst

20 hours ago


Manila, National Capital Region, Philippines beBeeClaims Full time $60,000 - $72,000

We are seeking a detail-oriented and analytical Medical Claims Specialist to join our team. As a key member of our organization, you will be responsible for maximizing insurance reimbursement for healthcare practice owners by identifying root causes of claim denials, underpayments, or delays and proposing effective resolutions.

Responsibilities
  • Better manage insurance claims processing by analyzing data and implementing corrective actions.
  • Develop and maintain positive relationships with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment.
  • Analyze medical insurance claim denial appeal processes and implement improvement strategies.
  • Work closely with practice owners and clinicians to complete and correct missing or incorrect data on their insurance claims.
Requirements
  • At least 6 months of experience in US-based AR follow-up and charge and payment posting.
  • A degree in Computer Engineering, Mathematics, or a related field.
  • Hands-on experience with data analysis and classification.
  • Strong analytical skills.
  • Familiarity with the US medical insurance industry and the 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 chiropractic, physical therapy, and mental/behavioral health specialties.
Essential Skills
  • High comfort level working on Eastern Time Zone/US Shift.
  • Good internet access at home.
  • Mobile Hotspot.
  • Laptop/Desktop with at least 8 GB of RAM.

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