Claims Resolution Specialist

21 hours ago

Paranaque City, Calabarzon, Philippines beBeeClaims Full time $60,000 - $80,000
Medical Claims Specialist Role

We are seeking a detail-oriented Medical Claims Specialist to support the revenue cycle operations of our healthcare client. This role is primarily focused on reducing claim denials and recovering aging or stale claims.

The successful candidate will work directly in the client's billing system, managing claim queues, and communicating with payers to ensure timely and accurate reimbursement.

  • Log into the client's billing system to review and manage denied or aging claims.
  • Work claim queues to identify root causes of denials and submit appropriate documentation or corrections.
  • Make outbound phone calls to insurance payers to check claim statuses, appeal denials, and resolve payment issues.
  • Escalate recurring denial trends or system/process bottlenecks to the client's RCM lead.
  • Maintain accurate and detailed notes of all payer interactions and claim activities.
Required Skills and Qualifications

The ideal candidate will possess 1-3 years of experience in medical billing, revenue cycle management, or claims follow-up.

Familiarity with payer portals and billing systems, such as Kareo, Athena, AdvancedMD, etc., is also essential.

Additionally, the candidate should have high attention to detail, strong written and verbal communication skills, and be comfortable speaking with payers over the phone and navigating insurance systems.

Benefits

This is an ideal opportunity for someone who thrives in a fast-paced, process-driven environment and has a passion for delivering high-quality results.

Others

This role offers flexibility and opportunities for growth and development in a dynamic organization.

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