Healthcare Claims Specialist

1 day 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

  • Patient Billing Specialist

    1 week ago

    Taguig, National Capital Region, Philippines Access Healthcare Full time ₱300,000 - ₱360,000 per year

    We are seeking a detail-oriented and organized Patient Billing Specialist to join our growing Healthcare BPO team. In this role, you'll handle end-to-end patient billing processes, ensure timely and accurate invoicing, and resolve billing discrepancies to support our clients in delivering seamless healthcare services.Key Responsibilities:Review and process...

  • Claims Specialist

    1 week ago

    Taguig, National Capital Region, Philippines WHR Global Consulting Full time ₱104,000 - ₱130,878 per year

    Position : Claims Assistant (Non-motor Insurance)Location : Alabang, Muntinlupa CitySetup : OnsiteSchedule : Day ShiftQualifications:Graduate of any 4-year bachelor's degree.2 – 4 years of experience in Non-Motor Claims or prior experience in a claims department or working with insurance claims is a significant advantage.Experience in handling...

  • Insurance Verification Specialist

    6 days ago

    Taguig, National Capital Region, Philippines Access Healthcare Full time ₱300,000 - ₱360,000 per year

    Job OverviewWe are looking for a Patient Eligibility Verification Specialist for our Voice Program, who will be responsible for verifying patients' insurance coverage and eligibility under Medicaid and Medicare. The role requires strong communication skills, attention to detail, and experience handling patient verification calls in a healthcare or BPO...

  • Claims Specialist

    6 days ago

    Taguig, National Capital Region, Philippines Igloo Full time ₱900,000 - ₱1,200,000 per year

    About Igloo Igloo (formerly Axinan) is the first full-stack insurtech firm to emerge from Singapore. With offices across Singapore, Indonesia, Thailand, the Philippines, Vietnam, Malaysia, China and India, Igloo is fueled by a mission of making insurance accessible and affordable for all. Igloo's innovation solutions empower companies to eliminate...

  • Medical Claims Specialist

    1 day ago

    Taguig, National Capital Region, Philippines Optum Full time ₱1,500,000 - ₱3,000,000 per year

    Job Qualifications:Completed at least 2 years of college.Minimum 12 months experience in Healthcare Account Receivable/Collections in a BPO setting.Familiarity with UB Claims and UB04 forms.Experience in medical billing/AR collections.Background in calling insurance (Payer) for claim status and payment disputes.Familiar with EPIC SYSTEM.Willing to work ...

  • Claims Specialist

    6 days ago

    Taguig, National Capital Region, Philippines Igloo Full time ₱900,000 - ₱1,200,000 per year

    About IglooIgloo (formerly Axinan) is the first full-stack insurtech firm to emerge from Singapore. With offices across Singapore, Indonesia, Thailand, the Philippines, Vietnam, Malaysia, China and India, Igloo is fueled by a mission of making insurance accessible and affordable for all. Igloo's innovation solutions empower companies to eliminate operational...

  • Healthcare Recruiters

    5 days ago

    Taguig, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱900,000 - ₱1,200,000 per year

    Access Healthcare is looking for Recruiters to join our team for a 3-month project-based role. The Recruiter will manage the end-to-end recruitment process, ensuring the timely acquisition of top talent for various roles. This is a fully remote position that requires a high level of autonomy and expertise in healthcare recruitment.Key Responsibilities:Manage...

  • Healthcare Claims Accounts Receivable Representative

    3 days ago

    Taguig, National Capital Region, Philippines Optum, a UnitedHealth Group Company Full time ₱900,000 - ₱1,200,000 per year

    This function is responsible for Collections for Healthcare unpaid claims. The position in this function interact with customers gathering support data to ensure invoice accuracy and also work through specific claims discrepancies. Provide input to policies, systems, methods, and procedures for the effective management and control of the premium collection...

  • Freight Claims Specialist

    5 days ago

    Taguig, National Capital Region, Philippines Hammerulo Data Corporation Full time ₱900,000 - ₱1,200,000 per year

    Freight Claims Specialist ( CSR with Logistic Background UPS / FEDEX etc.)Responsible for the daily execution of filing, reconciliation, and closure of all freight claims toward judicious resolution through effective and timely communication with all relevant parties during a claim's lifecycle.Handles freight claims disputes, investigation, and settling...

  • Claims and Reconciliation Specialist

    5 days ago

    Taguig, National Capital Region, Philippines J-K International Language Center Full time ₱300,000 - ₱360,000 per year

    Company: This company provides strategic consulting to help businesses define their digital transformation goals. The are also known for providing good services in technology, consulting and outsourcing services.Position: Claims and Reconciliation Specialist Company Industry: IT CompanyLocation: McKinley TaguigSalary Offer: Php 25,000 - Php 30,000Work...