Medical Claims Analyst

1 day ago

Pasig, National Capital Region, Philippines Risewave Consulting, Inc. Full time ₱150,000 - ₱250,000 per year

Job description:

The ideal candidate will have a basic understanding of healthcare claims and reimbursement processes, strong communication skills, and the ability to remain composed during challenging interactions. If you're passionate about helping others and thrive in a fast-paced call center environment, we'd love to hear from you.

Duties and Responsibilities

  • Respond to patient inquiries, requests, and disputes over the phone by clarifying, researching, locating, and providing accurate information.
  • Demonstrate basic working knowledge of healthcare claims processing
  • Understand fundamental concepts in healthcare reimbursement methodologies and the revenue cycle.
  • Analyze, identify, and resolve issues on patient accounts with accuracy and professionalism.
  • Interact cooperatively and courteously with patients, visitors, co-workers, management, and clients.
  • Adhere to all policies and procedures established for the client and team.
  • Meet and maintain daily productivity standards as outlined in departmental policies.
  • Meet and maintain quality standards in accordance with departmental expectations.
  • Maintain confidentiality at all times and comply with HIPAA and PHI guidelines.
  • Remain composed and professional when handling difficult or escalated customer calls.
  • Perform all tasks related to the Call Center Department's areas of responsibility.
  • Carry out other related duties and special projects as assigned.

Qualifications

  • At least 1 year of experience in Customer Service handling Healthcare claims/billing
  • Ability to work independently and collaboratively in a team environment
  • Proficiency in Microsoft Office applications
  • Strong verbal communication skills
  • Strong organizational and time management abilities
  • English-speaking proficiency required; bilingual skills are a plus
  • Ability to remain calm and professional when handling difficult customer calls

Work Setup: 100% onsite

Work location: Ortigas Pasig City

Work Schedule: Night shift

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