Senior Medical Claims Analyst

1 day ago


Baguio City, Cordillera, Philippines beBeeInsurance Full time ₱200,000 - ₱270,000
Medical Insurance Claim Specialist Opportunity

This position presents an exciting chance to leverage expertise in medical insurance claims processing and contribute to a dynamic team.

About the Role
  • Analyze complex medical claim denials, underpayments, and delays to propose effective resolutions.
  • Negotiate with US-based insurance carriers to resolve unpaid claims, delayed processing, and underpayment.
  • Plan and execute medical insurance claim denial appeal processes.
  • Collaborate with clinicians and practice owners to rectify missing or incorrect data on insurance claims.
Requirements
  • A minimum of 6 months experience in US-based AR follow-up and charge/payment posting.
  • Proficiency with the US medical insurance industry and insurance claims processing cycle.
  • Thorough knowledge of ICD-10, CPT, and HCPCS coding systems.
  • Familiarity with CMS-1500 and UB-04 claim formats.
  • Experience with Vericle Software is essential.
  • Excellent communication, problem-solving, and self-motivation skills.
  • Ability to work independently and manage time effectively.
Preferred Qualifications
  • Comfort working on Eastern Time Zone/US Shift.
  • Reliable internet access at home.
  • Mobile hotspot.
  • Laptop/Desktop with at least 8 GB of RAM.

This is an entry-level, full-time position within the healthcare provider industry.



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