Healthcare Specialist

1 day ago

Makati City, National Capital Region, Philippines EMAPTA Full time ₱900,000 - ₱1,200,000 per year

The Medical Records Specialist is responsible for analyzing claims eligible for arbitration. This individual should possess superior communication and computer skills including familiarity, Microsoft Outlook, Word and Excel. This individual will review, analyze and report reimbursement of integrity measures.

Job Overview:

Employment type: Full-time

Schedule: Day shift

Work setup: Onsite

Site Assignment: PNB Makati

Role Overview:

  • Analyze claim reports to determine claims eligible for Arbitration for both ERISA/NSA claims as well as state insurance department claims
  • Prepare claims for submission to the appropriate portals for arbitration
  • Have the ability for re-prioritize key tasks and meet with manager and director to provide updates of findings and outcomes
  • Work with external vendors such as State Department of Insurance (DOI) personnel and arbitrators to assist with issues and resolutions
  • Complete special projects and other duties as assigned

Qualifications:

  • Minimum of 1 year Medical Billing/Healthcare Support Experience
  • Knowledge of laws that regulate communication and privacy acts. HIPAA laws and understanding of the application of all above
  • Must maintain professional appearance.
  • Ability to be at work on a regular and consistent basis
  • Strong computer skills including Microsoft Office with a strong proficiency in Excel spread sheets, using formulas, pivot tables, filters, etc.
  • Strong organizational, analytical, and problem-solving skills
  • Knowledge of the insurance industry
  • Proven success in negotiation and technical writing
  • Professionalism in all dealings, both internal and external
  • Ability to clearly communicate, both verbally and in writing
  • Knowledge of medical terminology
  • Other duties as assigned

Job Type: Full-time

Benefits:

  • Health insurance

Application Question(s):

  • Do you have knowledge in HIPAA Regulations?
  • How many years of experience do you have working in Healthcare Industry?
  • Have you supported a US based client?
  • Are you willing to work fully onsite in Makati?

Experience:

  • Medical records: 1 year (Preferred)

Work Location: In person

  • Healthcare Credentialing Specialist

    1 day ago

    Makati City, National Capital Region, Philippines Penbrothers Full time ₱350,000 - ₱700,000 per year

    About PenbrothersPenbrothers is an HR & remote talent management partner and one of the fastest growing companies in the Philippines. We provide talented Filipinos with global opportunities in high-growth startups and dynamic companies, from the comfort of their own homes.About the ClientOur client is a fast-growing healthcare staffing agency dedicated to...

  • Radiographer / MRI Tech (Xray CT and Pet-CT) (Working location: Hong Kong)

    3 days ago

    Makati City, National Capital Region, Philippines EC Healthcare Full time ₱900,000 - ₱1,200,000 per year

    About EC Healthcare​EC Healthcare is Hong Kong's largest non-hospital medical service provider, leveraging its core businesses of preventive and precision medicine, and committed to developing medical artificial intelligence by integrating its multi-disciplinary medical services. Aligning with our mission - to bring health, beauty and happiness to...

  • Healthcare Compliance

    4 weeks ago

    Makati City, National Capital Region, Philippines Pride Global Full time

    Healthcare Compliance & Credentialing SpecialistAbout the CompanyPride Global is a minority-owned integrated human capital solutions & advisory firm with operating companies worldwide, including PrideOne, Russell Tobin, PrideBPO, PrideHealth, PrideNow, and Pride India. The company focuses on a diverse array of human resources solutions such as managed...

  • Sales Training Delivery Manager

    6 days ago

    Makati City, National Capital Region, Philippines Maxicare Healthcare Corporation Full time ₱400,000 - ₱1,200,000 per year

    Company DescriptionMaxicare Healthcare Corporation, established in 1987, is a pioneer in the health maintenance organization (HMO) industry in the Philippines. As the largest HMO provider in the country, Maxicare offers comprehensive healthcare programs through its extensive network of medical providers and strong customer support system. Currently serving...

  • Healthcare Specialist

    1 week ago

    Makati City, National Capital Region, Philippines Strategic Staffing Solutions Full time ₱900,000 - ₱1,200,000 per year

    STRATEGIC STAFFING SOLUTIONS (S3)Position: Healthcare Insurance AnalystWork Set-Up: OnsiteOffice Location:Century Tower, Makati CitySchedule:Night Shift (EST)JOB RESPONSIBILITIESConduct comprehensive audits on group members to evaluate their health insurance coverage, encompassing medical, dental, vision, and hearing benefits.Integrate modified membership...

  • Application Specialist

    3 days ago

    Quezon City, National Capital Region, Philippines VITALINE HEALTHCARE INC. Full time ₱1,200,000 - ₱2,400,000 per year

    About the role Vitaline Healthcare seeking a highly skilled Application Specialist to join our team in Quezon City, Metro Manila. In this full-time position, you will play a crucial role in supporting our clients in the healthcare industry with the effective utilization of our cutting-edge medical technology products and services.Key ResponsibilitiesConduct...

  • Healthcare Specialist

    1 week ago

    Caloocan City, National Capital Region, Philippines Sapient Global Services Full time ₱170,000 - ₱300,000 per year

    Easy and Fast One-day Hiring Process Earn up to 25k monthly plus more benefits We are looking for a Healthcare Specialist Representative in our Metro Manila Sites This is for urgent hiring, don't miss this opportunity and Apply NowResponsibilities:Answer inquiries regarding medical services, insurance coverage, and billing via phone calls.Assist patients...

  • Marketing Specialist

    1 day ago

    Makati City, National Capital Region, Philippines EG HEALTHCARE INC Full time ₱240,000 - ₱300,000 per year

    Bachelor's degree in Marketing, Communications or any related course.Thorough knowledge of social media and web analytics.Better with minimum 2 years experience in aesthetics, medical or healthcare marketing.Preferably with experience as content creator.Job Type: Full-timePay: Php20, Php25,000.00 per monthBenefits:Company Christmas giftCompany eventsHealth...

  • Healthcare Specialist

    3 days ago

    Makati City, National Capital Region, Philippines Spoke Full time $40,000 - $60,000 per year

    Job descriptionAbout Our ClientOur client is a modern benefits platform and full-service brokerage firm committed to helping companies create healthier workplaces. They combine expertise from benefits firms, technology startups, and insurance carriers to deliver a range of innovative solutions that empower employers and employees alike. Licensed in all 50...

  • Follow-up MD Assistant/Nurse

    3 days ago

    Makati City, National Capital Region, Philippines Halcyon Marine Healthcare Systems Inc. Full time ₱60,000 - ₱120,000 per year

    Job description:Updates Pre-employment Medical (PEME) based on guidelines.Verifies patient's medical records and assists Follow-up MDs and patients.Assists in Check listing on Doctors' notes.Prepares referrals to specialists.Uploads results and encodes clearance in the patient PEME. Job Qualifications:Graduate of any medical and allied courses.Preferably...