Claims Management Expert

2 weeks ago


Quezon City, National Capital Region, Philippines Sourcefit DR Full time

About the Opportunity:

We are seeking a highly skilled Financial Services Coordinator to join our team. In this role, you will be responsible for handling all aspects of claims management, from investigation to resolution. You will review and analyze the status of claims, identify potential issues, and develop effective solutions to ensure claim payments.

Main Responsibilities:

  • Navigate different online portals to check the status of claims.
  • Communicate with payers, responding to inquiries, clarifying information, and obtaining status updates.
  • Investigate claim denials, gathering information, analyzing data, and developing effective solutions to ensure claim payments.
  • Manage claim adjustments, resubmitting claims, requesting reprocessing, sending corrected claims, and/or creating appeals as needed.
  • Follow up on outstanding claims, diligently and promptly addressing any open and unpaid claims until the Accounts Receivable list is cleared up.

Requirements and Skills:

  • Minimum 3 years' experience in an accounts receivable role, with a focus on healthcare claims management.
  • Excellent navigation and usage skills for various online systems and portals.
  • Strong verbal and written communication skills for effective liaison with payers and internal stakeholders.
  • Proven analytical and problem-solving skills for effective resolution of claim denials.
  • High attention to detail and accuracy in all tasks.
  • Able to work under pressure and manage multiple priorities.
  • Proficient in using accounts receivable software and other standard office software.


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