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Medical Claims Specialist

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Makati City, National Capital Region, Philippines beBeeClaims Full time ₱40,000 - ₱60,000
Medical Claims Specialist

We are seeking an experienced Medical Claims Specialist to collaborate with our team. This role involves verifying patient eligibility, reviewing patient bills, and communicating with insurance companies.

Responsibilities:
  • Verify patient eligibility and benefits for treatments, hospitalizations, and procedures.
  • Review patient bills for accuracy and completeness.
  • Follow up on unpaid claims within the standard billing cycle timeframe.
  • Communicate with insurance companies regarding discrepancies in payments.
  • Identify and bill secondary or tertiary insurances.
Customer Support:
  • Provide support through phone, email, and chat channels.
  • Resolve customer issues and address inquiries to ensure satisfaction.
  • Collaborate with colleagues to resolve complex issues.
  • Maintain accurate records of customer interactions.
Requirements:
  • 6-12 months of BPO experience in a US Healthcare account.
  • Familiarity with US Healthcare Insurance (Medicare, Medicaid).
  • Excellent verbal and written English skills.
  • Ability to display empathy and patience in addressing customer concerns.
  • Strong problem-solving skills.
  • Adaptability to a changing work environment.
  • Ability to remain calm under pressure.
  • Proficiency in using computer systems and relevant software.
  • Amenability to working night shifts.