Medical Claims Specialist

2 days ago

Pasig, National Capital Region, Philippines Risewave Consulting, Inc. Full time ₱20,000 - ₱40,000 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

  • Fresh graduates are welcome to apply
  • 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

  • Medical Claims Specialist

    1 week ago

    Pasig, National Capital Region, Philippines Connext Global Solutions Inc Full time ₱40,000 - ₱80,000 per year

    Job SummaryThe Medical Claims Specialist is responsible for the timely submission of technical or professional medical claims to insurance companies. This role involves verifying patient and billing information, editing claims for compliance, resolving denials, and communicating with both payers and internal teams.Responsibilities• Utilize various...

  • Medical Claims Specialist

    1 week ago

    Pasig, National Capital Region, Philippines Connext Full time ₱400,000 - ₱800,000 per year

    Job SummaryThe Medical Claims Specialist is responsible for the timely submission of technical or professional medical claims to insurance companies. This role involves verifying patient and billing information, editing claims for compliance, resolving denials, and communicating with both payers and internal teams.Responsibilities• Utilize various...

  • Medical Claims Analyst

    2 days ago

    Pasig, National Capital Region, Philippines Lennor Group Full time

    Our brand, Lennor Metier Consulting , a DOLE-licensed headhunting and recruitment agency in the Philippines, is proud to partner with a global RCM Company in their search for a Medical Claims Analyst based in Ortigas .Industry: HealthcareSalary Range: ₱35,000 PackageWork Setup: OnsiteWork Schedule: Night ShiftLocation: OrtigasJob OverviewWe are looking for...

  • Medical Claims Analyst

    1 week ago

    Pasig, National Capital Region, Philippines MED-METRIX INTERNATIONAL PH-I, INC. Full time ₱250,000 - ₱450,000 per year

    Join our dynamic team and make a meaningful impact in the healthcare industry. As a Medical Claims Analyst, you'll play a pivotal role in ensuring accurate claims processing while advancing your career in a supportive and innovative environment. Enjoy competitive benefits upon hire, ongoing professional development, and the satisfaction of helping others...

  • Medical Claims Analyst

    3 hours ago

    Pasig, National Capital Region, Philippines Comrise Full time ₱72,000 - ₱96,000 per year

    Job Purpose:The Medical Claims Analyst is responsible for collections, account follow up, billing and allowance posting for the accounts assigned to them.Duties and Responsibilities:Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websitesMeets and maintains daily productivity/quality standards...

  • Medical Claims Analyst- AR

    2 weeks ago

    Pasig, National Capital Region, Philippines HCM Nexus Full time $40,000 - $60,000 per year

    Job DescriptionWe are looking for a Medical Claims Analyst (AR) to join our growing US Healthcare team. This role involves handling both inbound and outbound calls (30% outbound) to ensure accurate and timely resolution of accounts receivable and medical claims. You'll collaborate with healthcare providers and insurance representatives to process claims...

  • medical records

    1 week ago

    Pasig, National Capital Region, Philippines Prime Hospital and Medical Center Pasig Full time ₱250,000 - ₱500,000 per year

    Duties and Responsibilities:A. Records ManagementMaintain and update patient medical records and hemodialysis treatment logs.Ensure completeness, accuracy, and confidentiality of all patient information.File and retrieve patient charts and records efficiently.Encode and track dialysis treatment sessions and laboratory results in the hospital system.B. ICD-10...

  • Medical Claims Representative

    6 days ago

    Pasig, National Capital Region, Philippines Eastvantage Business Solutions Full time ₱336,000 - ₱396,000 per year

    Urgently hiring Customer Support Specialists for our Healthcare – Claims Processing Account. If you're passionate about helping others, detail-oriented, and ready to thrive in a dynamic environment, we want you on our teamWhat You'll Do:Handle inbound and outbound calls related to healthcare claimsAssist members and providers with claim status, coverage,...

  • Claims Specialist

    1 week ago

    Pasig, National Capital Region, Philippines Eastvantage Business Solutions Full time ₱250,000 - ₱330,000 per year

    We're Hiring: Customer Service Representative (Healthcare/Medical Account)Onsite | Night Shift | Competitive SalaryAre you a seasoned CSR professional with a passion for healthcare and helping others? We're looking for a dedicated Customer Service Representative to join our team and support a leading Healthcare/Medical Account.Role Overview:As a CSR expert,...

  • Claims Benefit Manager

    2 days ago

    Pasig, National Capital Region, Philippines Hive Health Full time ₱1,200,000 - ₱1,500,000 per year

    Ready to make an impact? At Hive Health and HPPI, a subsidiary of Hive Health, we're on a mission to make healthcare radically more accessible for all-and we need passionate, driven individuals to help us make it happen. If you thrive in a fast-paced, innovative environment and want to work on solutions that truly matter, we'd love to meet youAbout the...