Healthcare Specialist

2 days 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

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