Healthcare Claims Specialist

4 hours ago

Ayala Alabang, National Capital Region, Philippines beBeeMedical Full time ₱450,000 - ₱750,000
Medical Claims Specialist

A Medical Biller plays a crucial role in the healthcare industry, responsible for submitting claims to insurance companies.

The successful candidate will process data from medical coders, ensuring timely payment of claims. Key responsibilities include verifying insurance coverage, reviewing denied claims, and assisting patients with billing questions.

Primary Tasks:
  • Manage patient inquiries, appointments, and data verification via inbound and outbound calls.
  • Resolving denials involves correcting denial claims and resubmitting claims electronically or in paper format to primary, secondary, and third-party insurance companies.
  • Record and verify explanation of benefits.
  • Administrative support includes data entry, verifying insurance, follow-ups, authorizations, and collections for outstanding balances and receivables.
Qualifications:
  • Demonstrate a strong interest in US Healthcare Claims Customer Service.
  • Excellent verbal and written English communication skills are essential.
  • Customer service experience in Insurance Billing is highly valued.
  • HIPAA Certification is preferred but not mandatory.
  • Candidates should possess attention to detail, impartiality, and high organization skills.
  • Computer literacy and a positive work attitude are also required.
System Requirements:
  • Device Specifications:
  • An Intel Core i5-5000 or AMD Ryzen 5 processor or higher is recommended.
  • 8GB RAM is the minimum requirement.
  • Windows 10/11 64-bit or macOS Ventura operating system must be used.
  • A USB-type headset with noise-cancelling feature is necessary.
  • Clear and crisp video output camera is essential.
  • Backup Device Specifications:
  • The backup device must have identical specifications to the primary device.
  • An optional backup device with a USB-type headset may be used.
  • Power Supply (UPS):
  • The UPS must power the workstation for at least 3 hours.
  • A typical UPS will have 240Wh or higher capacity.
  • The UPS must accept all plugs required to maintain the primary device and work environment.
  • Internet Connection:
  • A DSL/Fiber Connection with a minimum speed of 8mb/s is required.

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