Healthcare Medical Claims Specialist

7 days ago


Biñan, Calabarzon, Philippines beBeeMedicalBilling Full time ₱250,000 - ₱350,000

We are seeking a highly skilled and detail-oriented professional to join our organization in the role of Medical Claim Specialist. In this position, you will be responsible for managing medical claims and insurance processes with accuracy and efficiency.

Key Responsibilities:
  • Claim Management: Accurately input claim information into the system, maintain organized spreadsheets, and track payments and denials.
  • Claims Resubmission: Resubmit denied or incorrect claims and resolve any related issues promptly.
  • Billing Reports: Prepare and deliver monthly claim billing reports and summaries.
  • Insurance Inquiries: Contact insurance agencies to address inquiries and resolve claim denials.
  • Workflow Management: Utilize tools such as ClickUp, Google Suite, and Trizetto Simple Claim to manage workflows effectively.
Requirements:
  • Medical Billing Experience: At least 1 year of experience in medical billing and claims management.
  • Technical Skills: Proficient in using ClickUp, Google Suite (Docs, Sheets, etc.), and Trizetto Simple Claim.
  • Attention to Detail: Strong attention to detail and accuracy in data entry.
  • Communication Skills: Excellent communication skills for handling insurance inquiries and resolving issues.
  • Problem-Solving: Ability to analyze claim denials and determine the best course of action.
  • Time Management: Self-motivated, organized, and capable of meeting deadlines in a fast-paced environment.
Work Environment:

A typical workday would involve working Monday to Friday, 9:00 AM – 6:00 PM in a structured environment with access to the latest tools and technology.

Benefits:
  • Professional Growth: Opportunity to develop and enhance your medical billing expertise.
  • Career Advancement: Potential for career advancement in the healthcare industry.
  • Work-Life Balance: A supportive and professional team environment that promotes work-life balance.


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