Medical Claims Professional

1 day ago


Tarlac City, Central Luzon, Philippines beBeeClaims Full time $40,000 - $50,000

Our organization is seeking a highly skilled and detail-oriented Medical Claims Analyst to join our team. If you have experience in maximizing insurance reimbursement for healthcare practice owners, we encourage you to apply.

Job Description
  1. Maximize insurance reimbursement for healthcare practice owners by ensuring accurate and timely claim submissions
  2. Investigate root causes of medical insurance claim denial, underpayment, or delay, and develop effective resolution strategies
  3. Establish strong relationships with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment
  4. Develop and execute medical insurance claim denial appeal processes to ensure optimal outcomes
  5. Collaborate with US-based practice owners and clinicians to complete and correct any missing or incorrect data on their insurance claims
Required Skills and Qualifications
  1. Minimum of 6 months experience in US-based AR follow-up and charge and payment posting
  2. College degree in Computer Engineering, Mathematics, or similar field
  3. Hands-on experience with data analysis and data classification
  4. Strong analytical skills and attention to detail
  5. Familiarity with US medical insurance industry and insurance claims processing cycle
  6. Knowledge of ICD-10, CPT, and HCPC coding systems
  7. Understanding of CMS-1500 and UB-04 claim formats
  8. Experience with Vericle Software is an advantage
  9. Excellent communication and problem-solving skills
  10. Self-motivated and able to work autonomously
  11. Experience working with chiropractic, physical therapy, and mental/behavioral health specialties
Benefits
  1. Opportunity to work with a dynamic and growing organization
  2. Competitive compensation and benefits package
  3. Professional development and growth opportunities
Others
  1. High comfort level working on Eastern Time Zone/US Shift
  2. Good internet access at home
  3. Mobile Hotspot
  4. Laptop/Desktop of at least 8 GB


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