Medical Claims Specialist
11 hours ago
We are seeking a highly skilled Medical Claims Specialist to join our team at Visaya Knowledge Process Outsourcing. As a key member of our healthcare accounts receivable team, you will be responsible for verifying patient eligibility, obtaining authorizations, and resolving claims denials.
Key Responsibilities- Verify patient eligibility and obtain authorizations through payer websites, client systems, or phone calls with insurance carriers
- Update patient demographics and insurance information in relevant systems
- Research and resolve unpaid or denied claims
- Monitor claims for missing information, authorization, and control numbers
- Research EOBs for payments or adjustments to resolve claims
- Communicate with payers via phone or written correspondence to secure payment of claims
- Access client systems for payment, patient, claim, and data information
- Follow guidelines for prioritization, timely filing deadlines, and notation protocols
- Secure medical documentation required by third-party insurance carriers
- Maintain patient confidentiality in accordance with insurance collection guidelines and corporate policy
- 2-3 years of experience in medical collections, denials, and appeals
- At least 6 months of experience with the EPIC tool
- Intermediate knowledge of ICD-10, CPT, HCPCS, and NCCI
- Intermediate knowledge of third-party billing guidelines and billing claim forms (UB04/1500)
- Intermediate working knowledge of Microsoft Word and Excel
- Intermediate knowledge of health information systems (EMR, claim scrubbers, patient accounting systems)
- Intermediate knowledge of patient accounting systems (EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon)
- Intermediate knowledge of the DDE Medicare claim system
- Intermediate knowledge of government rules and regulations
This is an onsite position located in Ortigas, Pasig City.
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Medical Claims Specialist
2 days ago
Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Corp Full timeJob Title: Medical Claims SpecialistWe are seeking a highly skilled Medical Claims Specialist to join our team at Visaya Knowledge Process Outsourcing Corp. As a Medical Claims Specialist, you will be responsible for verifying patient eligibility and authorization, updating patient demographics and insurance information, and researching claims for missing...
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Medical Claims Specialist
2 days ago
Pasig, National Capital Region, Philippines Visaya Knowledge Process Outsourcing Corp Full timeJob Title: Medical Claims SpecialistWe are seeking a highly skilled Medical Claims Specialist to join our team at Visaya Knowledge Process Outsourcing Corp. As a Medical Claims Specialist, you will be responsible for verifying patient eligibility and authorization, updating patient demographics and insurance information, and researching claims for missing...
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