Healthcare Revenue Cycle Expert

1 day ago

Cebu City, Central Visayas, Philippines beBeeMedicine Full time ₱550,000 - ₱750,000
Medical Claims Specialist

The Medical Claims Specialist plays a vital role in the healthcare revenue cycle by ensuring the accurate and timely processing of medical claims.

  • Claim Submission: Prepare and submit accurate medical claims to insurance payers, adhering to coding and billing standards.
  • Accounts Receivable Management: Monitor accounts for payment status, follow up on unpaid claims, and take necessary actions to resolve denied or rejected claims.
  • Patient Interaction: Communicate with patients regarding their accounts, explain charges, and assist with billing inquiries.
  • Insurance Verification: Verify patient insurance eligibility and benefits prior to services being rendered.
  • Payment Posting: Accurately post payments received from insurance companies and patients to the appropriate accounts.
  • Documentation: Maintain accurate and detailed documentation of billing processes, including records of claims submitted and payments received.
  • Compliance: Ensure compliance with HIPAA regulations and maintain confidentiality of patient information.
Required Skills and Qualifications
  • Education: High School Diploma or equivalent; certification in medical billing or coding is a plus.
  • Experience: Previous experience in medical billing or a related field is preferred, but entry-level candidates may be considered.
  • Knowledge: Familiarity with medical terminology, coding systems (CPT, ICD-10), and healthcare payer processes.
  • Skills: Strong attention to detail and accuracy in claim submissions; excellent organizational and time-management skills; good communication and interpersonal skills to interact with patients and insurance representatives; proficiency in using medical billing software and electronic health record systems.
Benefits and Opportunities

A competitive salary and benefits package. Opportunity for growth and career development. Training and support to enhance technical and customer service skills. Work in a dynamic and multicultural environment.

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