Healthcare Claims Specialist

5 hours ago

Taguig, National Capital Region, Philippines Systemantech Full time ₱300,000 per year

This role is responsible for timely and accurate

resolution of account receivables either through insurance payment collections, adjustment, or write offs.

This job description will be reviewed periodically and is subject to change by management.

RESPONSIBILITIES:

➢ Performs AR follow-up on assigned accounts taking into account Timely Filing Limits

set by the payer.

➢ Submits adjustments or write-off requests for approval to resolve outstanding account

balances.

➢ Submits medical record packets for submission to the payer for claims reprocessing,

reconsideration or appeal requests.

➢ Receives inbound calls/ call backs from payers/insurances regarding accounts that

they are actively working on.

➢ Resolves claim rejections accordingly in order to release a clean claim to the payer.

➢ Responds to e-mail inquiries from different departments regarding pending insurance

balances or claim denials.

➢ Maintains accurate and detailed notes/documentation in applicable systems.

➢ Keeps Supervisor and/or Manager informed of system issues.

➢ Observes legal and ethical guidelines for safeguarding patient and company

confidentiality (HIPAA).

➢ Other duties as assigned.

BASIC QUALIFICATIONS | EDUCATION:

➢ Completed at least 2 years in College or with an Associate or Bachelor's Degree

➢ Excellent oral and written communication skills

➢ Thorough understanding of the US Healthcare Insurance claims

PREFERRED QUALIFICATIONS:

➢ Proficient Medicare and solid general payer knowledge

➢ Has the ability to read and interpret explanation of benefits

➢ Basic Excel, Word and Outlook experience required

➢ Typing using computer keyboards, 10-key pads and calculators

➢ Strong Computer/Software Skills

➢ Detail-oriented

➢ Typing speed of 35 wpm

➢ Occasional weekend work may be required

➢ Must be flexible to work on a night shift (between 6pm to 10am) Philippine Standard

Time.

➢ Must be amenable to work on Overtime or during Rest Days when business requests

for additional (paid) hours

COMPETENCIES:

➢ Internal – At least 1 year tenure in ACH

➢ External – 1 year of experience in Healthcare Insurance Collections and/or

Correspondence

Job Type: Full-time

Pay: Up to Php30,000.00 per month

Benefits:

  • Additional leave
  • Company events
  • Health insurance
  • Opportunities for promotion
  • Promotion to permanent employee

Ability to commute/relocate:

  • Taguig: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

  • Please provide your Viber number for faster communication.

Experience:

  • Healthcare Insurance Collections: 1 year (Required)

Location:

  • Taguig (Required)

Work Location: In person

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