Healthcare Claims Specialist

2 days ago


Marikina City, National Capital Region, Philippines beBeeMedical Full time ₱25,000 - ₱40,000
Job Overview

As a Medical Claims Professional, you will be responsible for accurately and efficiently processing patient accounts by posting medical charges, payments, and journal entries.

Key Responsibilities
  • Work directly with patients, healthcare providers, and insurance companies to process and pay claims in a timely manner.
  • Verify correct insurance information on behalf of the client and patient, including eligibility verification and precertification.
  • Prepare, review, and transmit claims using electronic billing software, following established procedures and guidelines.
  • Follow up on unpaid claims within the standard billing cycle time frame, researching and resolving any issues that may arise.
  • Meet individual and departmental standards with regard to quality, productivity, and accuracy.
Additional Requirements
  • Able to perform eligibility verification and precertification through electronic systems or verbally with insurance companies.
  • Call insurance companies to obtain claim status and document it in the system.
  • Review patient bills for accuracy and completeness, obtaining any missing information as needed.
  • Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid programs.


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