Healthcare Claims Specialist

11 hours ago


Bacoor, Calabarzon, Philippines beBeeClaims Full time ₱416,000 - ₱524,800

Job Title: Healthcare Claims Specialist

Job Description

The ideal candidate will possess strong attention to detail, a liking for systems and processes, and excellent written and oral communication skills.

We are seeking an organized and efficient individual to verify insurance coverage for new and existing patients. The selected candidate will be responsible for coding claims according to insurer guidelines and submitting them electronically within the required timeframe.

This role involves reconciling payments with bank accounts and maintaining up-to-date credentialing with each insurer for added providers or departures.

Key Responsibilities:
  • Verify Insurance Coverage: Confirm patient insurance details and ensure accurate billing information.
  • Claim Coding and Submission: Code claims according to insurer guidelines and submit electronically within 72 hours of receiving claims data.
  • Clinical Query Resolution: Correct and resubmit denied claims within 7 days of receipt.
  • Payment Reconciliation: Reconcile payments with bank accounts and contact insurers as needed to resolve discrepancies.
  • Credentialing Management: Maintain up-to-date credentialing with each insurer for added providers or departures.

Benefits of the Role: The selected individual will work closely with our team to ensure seamless claim processing and accurate reimbursement.



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