Medical Claims Specialist

1 day ago


Makati City, National Capital Region, Philippines beBeeMedical Full time $40,000 - $55,000
Job Summary

The Medical Billing Specialist is responsible for monitoring medical claims, investigating rejections and denials, and documenting account activities. This role involves posting adjustments, managing collections from various payers, and maintaining a deep understanding of eligibility requirements and payment methodologies.

Key Responsibilities
  • Verify patient coverage and benefits
  • Review and submit claims in a timely manner
  • Obtain prior authorizations to support claim approvals
  • Monitor claim status and conduct follow-up to ensure prompt payment
  • Research and resolve claim rejections and denials
  • Generate and submit patient statements
  • Document account activities accurately and promptly
  • Post manual payments, apply adjustments, and manage collections
Requirements
  • At least 2 years of experience in revenue cycle processes, including eligibility verification, charge review, claims submission, AR follow-up, and denial management
  • Experience with DME and Apero is preferred
  • Ability to work collaboratively with team members and healthcare providers
  • Excellent customer service skills
Benefits
  • Permanent work-from-home opportunity
  • Flexible schedule
  • Opportunity to work with a diverse range of payers


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