Medical Collections Specialist

1 day ago

Quezon City, National Capital Region, Philippines 5dc130d8-d2ef-4ec4-8628-bf05673ea654 Full time ₱1,200,000 - ₱2,400,000 per year

The Medical Collections Specialist is responsible for assisting in the collection and resolution of outstanding insurance claims for behavioral health services. This role focuses on checking status claims with insurance payers, identifying and addressing incorrect denials, and ensuring timely and accurate follow-up to secure proper reimbursement. The specialist will work closely with lead collectors to maintain communication, document actions taken, and ensure daily productivity goals are met.

Essential Duties & Responsibilities:

  • Contact insurance payers via phone or online portals to obtain claim status updates and resolve claim issues.

  • Review and identify common claim denials and take appropriate corrective action.

  • Maintain a working knowledge of accounts receivable (AR) management and payer guidelines.

  • Work a minimum of 30–50 claims per day with accuracy and efficiency.

  • Communicate effectively with lead collectors regarding claim trends, payer issues, or accounts requiring escalation.

  • Document detailed notes for each payer interaction, including claim status, representative details, and next steps for resolution.

  • Contact insurance payers via phone to status medical records and appeals as directed by the lead collector.

  • Send a daily email summary outlining action items, completed tasks, and any unresolved issues requiring follow-up.

Qualifications:

  • Basic understanding of medical claims and insurance collections processes.

  • Familiarity with payer portals and claim status tools.

  • Strong communication and organizational skills.

  • Attention to detail and ability to document accurately.

  • Prior experience in medical billing or behavioral health setting preferred but not required.

Performance Expectations:

  • Maintain consistent productivity of 30–50 claims daily.

  • Demonstrate professional communication with payers and internal team members.

  • Accurately document claim actions and communicate daily updates to lead collectors.

Job Types: Full-time, Permanent

Benefits:

  • Health insurance

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