Medical Insurance Claim Analyst

6 days ago


Caloocan City, National Capital Region, Philippines beBeeInsurance Full time $45,000 - $57,000
Job Opportunity

We are seeking a Medical Insurance Claim Analyst to optimize insurance reimbursement for healthcare providers. This role involves investigating root causes for medical insurance claim denial, underpayment, or delay and proposing resolutions.

Key Responsibilities
  • Optimize insurance reimbursement for healthcare providers
  • Investigate root causes for medical insurance claim denial, underpayment, or delay and propose resolutions
  • Interact with insurance carriers to follow-up on unpaid claims, delayed processing, and underpayment
  • Plan and execute medical insurance claim denial appeal process
  • Interact with practice owners and clinicians to complete and correct missing or incorrect data on their insurance claims
Qualifications
  • Minimum 6 months experience in AR follow-up and charge and payment posting
  • College degree in Computer Science, Mathematics, or related field
  • Hands-on experience with data analysis and classification
  • Good analytical skills
  • Familiarity with the US medical insurance industry and insurance claims processing cycle
  • Knowledge of ICD-10, CPT, and HCPC
  • Understanding of CMS-1500 and UB-04 claim formats
  • Experience with Vericle Software is an advantage
  • Excellent communication and problem-solving skills
  • Self-motivated and able to work independently
  • Experience with chiropractic, physical therapy, and mental/behavioral health specialties

The ideal candidate will have a high comfort level working on Eastern Time Zone/US Shift, good internet access at home, mobile hotspot, and a laptop/desktop of at least 8 GB.



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