Medical Insurance Claims Specialist

2 days ago

Manila, National Capital Region, Philippines beBeePatientAccount Full time ₱800,000 - ₱1,200,000
Patient Account Representative Role Overview

This mid-senior level position involves working with patients and handling their medical insurance claims. As a representative, you will be responsible for ensuring that patients receive the necessary medical care without any financial burdens.

Key Responsibilities:

  • Perform detailed insurance verification to identify coverage for various medical procedures.
  • Communicate effectively with Spanish-speaking patients regarding their insurance details, authorization requirements, and out-of-pocket estimates.
  • Flag non-covered services or potential coordination of benefits issues for further review.
  • Initiate and follow up on prior authorization requests, including appeals if necessary.
  • Maintain organized tracking logs for authorizations and coverage status.
  • Act as a subject matter resource to junior staff members in resolving pre-service issues.
  • Work closely with clinical departments to ensure accurate scheduling for covered services.

Requirements:

  • Fluency in both Spanish and English (verbal and written).
  • Associate's degree or equivalent work experience.
  • At least 3 years of experience in a medical office or insurance verification role.
  • Strong understanding of commercial, government, and exchange-based insurance plans.
  • Proficient in verifying coverage for high-cost services such as imaging, injections, and procedures.
  • Excellent attention to detail and documentation skills.
  • Familiarity with EMR systems, preferably eClinicalWorks.

Preferred Skills:

  • Experience handling insurance verification for U.S.-based healthcare providers.
  • Ability to handle patient communications with empathy and professionalism in both Spanish and English.

About This Opportunity:

  • Join a dynamic team dedicated to providing exceptional patient care.
  • Develop your expertise in insurance verification and patient communication.

Benefits:

  • Competitive salary and benefits package.
  • Opportunities for professional growth and development.
  • A supportive and inclusive work environment.

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