Medical Claims Analyst

1 day ago


Baguio City, Cordillera, Philippines beBeeExperience Full time ₱440,000 - ₱620,000
Job Overview

The Medical Billing Specialist role is a vital component of our healthcare organization. This critical position involves monitoring medical claims, investigating rejections and denials, and documenting account activities.

Key Responsibilities
  • Verify patient eligibility and benefits to ensure accurate coverage.
  • Submit claims in a timely and compliant manner.
  • Obtain prior authorizations for smooth claim approvals.
  • Monitor claim status and conduct follow-ups for prompt payment.
  • Research and resolve claim rejections and denials.
  • Generate patient statements without interaction.
  • Document all account activities accurately.
  • Manage collections from various payers.
  • Understand and apply Medicare, Medicaid, and commercial insurance requirements.
  • Record contractual adjustments based on payer contracts and government regulations.
Requirements
  • A minimum of 2 years' experience in end-to-end revenue cycle processes.
  • A strong background in charge review, claims submission, AR follow-up, denial management, and collections.
  • Ability to work collaboratively with team members and healthcare providers.
  • Excellent customer service skills.


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