Medical Claims Specialist

2 days ago


Cebu City, Central Visayas, Philippines beBeeClaims Full time ₱50,000 - ₱79,000

Medical Claims Coordinator

The Medical Claims Coordinator plays a vital role in ensuring accurate and timely medical claims submissions to insurance companies.

This position requires strong knowledge of medical billing and coding processes, as well as effective communication skills for interacting with patients and insurers.

Key Responsibilities:

  • Claim Preparation & Submission: Prepare and submit medical claims to insurance companies, adhering to industry standards and guidelines.
  • Billing & Coding: Verify patient billing and coding for procedures, diagnoses, and treatments to ensure correct reimbursement.
  • Accounts Receivable Management: Monitor accounts for unpaid balances, follow up on outstanding claims, and resolve denied or rejected claims through appeals processes.
  • Insurance Verification: Verify patient insurance coverage, benefits, and eligibility prior to services being rendered.
  • Patient Communication: Handle patient inquiries related to their bills, explain charges, and assist in setting up payment plans if necessary.
  • Compliance: Ensure billing procedures comply with industry regulations, including HIPAA, and stay up-to-date with changes in medical billing and coding standards.
  • Documentation & Reporting: Maintain accurate billing records and reports, ensuring timely filing and proper documentation for audits.

Requirements:

  • Education: High School Diploma or equivalent required; certification in medical billing or coding preferred.
  • Experience: 1-3 years of experience in medical billing, preferably in a healthcare setting.
  • Skills:
    • Proficient in medical billing software and electronic health records systems.
    • Excellent attention to detail and organizational skills.
    • Strong communication skills for dealing with insurance companies and patients.


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