Medical Claim Administrator

15 hours ago


Manila, National Capital Region, Philippines beBeeMedicare Full time ₱450,000 - ₱850,000
Job Position Overview

The Medical Billing Specialist plays a critical role in our healthcare team's operational efficiency.

Key Responsibilities and Expectations
  1. Verify patient eligibility and benefits to ensure accurate coverage for compliant claims submissions.
  2. Submit claims in a timely and compliant manner, adhering to regulatory requirements and industry standards.
  3. Obtain prior authorizations for smooth claim approvals, ensuring seamless payment processing.
  4. Monitor claims status and conduct follow-up for prompt payment resolution.
  5. Research and resolve claim rejections and denials, applying problem-solving skills and technical knowledge.
  6. Generate and submit patient statements without requiring direct interaction.
  7. Document all account activities accurately and promptly, maintaining clear records of transactions and communications.
  8. Post payments, apply adjustments, and manage collections from various payers, handling financial data with precision and attention to detail.
  9. Understand and apply Medicare, Medicaid, and commercial insurance requirements, staying up-to-date on relevant regulations and guidelines.
Essential Qualifications and Skills
  • A minimum of 2 years' experience in revenue cycle processes, encompassing eligibility verification, charge review, claims submission, and denial management.
  • A strong understanding of end-to-end revenue cycle processes and related technologies, facilitating efficient workflow and effective collaboration.
  • Excellent customer service skills for interacting with various stakeholders, delivering professional communication and resolving issues in a courteous and timely manner.


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