Medical Claims Processor

The Claims Processor is responsible for reviewing, verifying, and processing insurance claims in accordance with company policies, industry regulations, and contractual guidelines. This role ensures accurate and timely adjudication of claims, identifies discrepancies or potential fraud, and provides high-quality service to policyholders, providers, and...

Philippine British Assurance Company Inc. is a privately owned and duly authorized non-life insurance company serving the Filipino community since 1960. We aspire to be the most trusted non-life insurer in the country, a partner that our customers can fully depend on.Our pioneering partnership with British firms Ker and Co., Sun Insurance, Phoenix Insurance...

1. Claims Inspection and ProcessingReceives and registers claims received by the Branch;Evaluates the claims received in accordance with established procedures and authority limits.Endorses to the Claims Department all filed claims beyond the branch's settling authority for proper processing.Conducts site inspection, as necessary.Monitors the progress of...

Key ResponsibilitiesReview denied medical claims to determine reasons for denial (coding errors, missing information, medical necessity, eligibility, etc.).Collect, organize, and verify supporting documentation needed for appeals or auditPrepare and submit claim audit packets for internal review or external payor reconsideration.Collaborate with clinical...

Southwestern University Medical Center, a Mount Grace partner and a tertiary general hospital that is committed to providing quality and reliable health services is looking for a detail-oriented MEDICAL TRANSCRIPTIONIST.The primary role of the MEDICAL TRANSCRIPTIONIST is the accurate filling out of PhilHealth CF4 claims form and overall assistance in...

Southwestern University Medical Center is looking for a Medical Transcriptionist who has a high attention to details and skilled in PhilHealth CF4 completion.The primary role of the Medical Transcriptionist is the accurate filling out of PhilHealth CF4 claims form and overall assistance in ensuring prompt accomplishment and submission of the PhilHealth forms...

Handles member's inquiries regarding billing and claims.Maintain clear and professional communication with customers, providing timely and accurate information.Qualifications:Education: College graduate with at least 6 months of experience in a BPO setting, preferably healthcare account.Experience: Proven experience in a customer service role, preferably...

1. Claims Inspection and ProcessingReceives and registers claims received by the Branch;Evaluates the claims received in accordance with established procedures and authority limits.Endorses to the Claims Department all filed claims beyond the branch's settling authority for proper processing.Conducts site inspection, as necessary.Monitors the progress of...

POSITION SUMMARY:Assists the Branch Head in providing the necessary services to all the Clients, Customers, Agents and Brokers maintaining the quality of services within the standards of the Company.ESSENTIAL FUNCTIONS:Receives claims and underwriting advice and assists client, agent or broker or representative on matters relative to the request.Inspects,...

About the Role We are a growing Durable Medical Equipment (DME) company building an in-house billing and collections team. We are seeking a Medical Billing & Collections Specialist to support billing, accounts receivable, and collections across Medicare, Medicare Advantage, and commercial insurance. Our primary product focus includes Continuous Glucose...