Claim Resolution Specialist

1 day ago


Calamba, Calabarzon, Philippines beBeeClaims Full time ₱250,000 - ₱400,000
Medical Claims Analyst Job

ClinicMind is seeking an experienced Medical Claims Analyst to join their team. As a key member of the revenue cycle management team, you will be responsible for maximizing insurance reimbursement for healthcare practice owners.

About This Role

This role involves analyzing and resolving medical insurance claims denials, underpayments, and delays. You will work closely with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment. Additionally, you will plan and execute medical insurance claim denial appeal processes.

Responsibilities
  • Maximize insurance reimbursement for healthcare practice owners
  • Analyze root causes for medical insurance claim denial, underpayment, or delay and propose resolutions
  • Interact with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment
  • Plan and execute medical insurance claim denial appeal process
Requirements
  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
  3. Familiarity with data analysis and data classification
  4. Knowledge of ICD-10, CPT, and HCPC
  5. Understanding of CMS-1500 and UB-04 claim formats
  6. Excellent analytical skills
  7. Good communication and problem-solving skills
What We Offer
  • Opportunity to work with a leading Electronic Healthcare Records (EHR) software provider
  • Collaborative and dynamic work environment


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