Healthcare Insurance Reimbursement Specialist

7 days ago


Dumaguete, Central Visayas, Philippines beBeeClaims Full time ₱350,000 - ₱500,000
Medical Claims Analyst

We are seeking a highly skilled Medical Claims Analyst to join our team. The ideal candidate will be responsible for maximizing insurance reimbursement for healthcare practice owners, identifying root causes of medical insurance claim denial or underpayment, and proposing effective solutions.

Key Responsibilities
  • Maximize Insurance Reimbursement: Ensure optimal payment from US-based insurance carriers for healthcare practice owners.
  • Claim Denial Analysis: Identify reasons for medical insurance claim denial, underpayment, or delay and propose effective resolutions.
  • Follow-up and Appeal Process: Plan and execute medical insurance claim denial appeal process with US-based insurance carriers.
  • Data Correction: Collaborate with healthcare practice owners and clinicians to complete and correct missing or incorrect data on insurance claims.
Requirements
  • Experience: Minimum 6 months experience in US-based AR follow-up and charge and payment posting.
  • Industry Knowledge: Familiarity with US medical insurance industry and insurance claims processing cycle.
  • Technical Skills: Knowledge of ICD-10, CPT, HCPC, CMS-1500, and UB-04 claim formats.
  • Software Proficiency: Experience in Vericle Software is essential.
  • Soft Skills: Excellent listening, communication, and problem-solving skills, self-motivated, and able to work autonomously.
Work Environment
  • Remote Work: Comfortable working from home with good internet access and necessary equipment.
  • Time Zone: High comfort level working on Eastern Time Zone/US Shift.

Our company offers a dynamic work environment and opportunities for growth and development.



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