
Medical Claims
6 days ago
Job Purpose
The representative 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 websites.
- Meets and maintains daily productivity/quality standards established in departmental policies.
- Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts.
- Adheres to the policies and procedures established for the client/team.
- Knowledge of timely filing deadlines for each designated payer.
- Performs research regarding payer specific billing guidelines as needed.
- Ability to analyze, identify and resolve issues causing payer payment delays.
- Ability to analyze, identify and trend claims issues to proactively reduce denials.
- Communicates to management any issues and/or trends identified.
- Initiate appeals when necessary.
- Ability to identify and correct medical billing errors.
- Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process.
- Understanding of under or over payments and credit balance processes.
- Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required.
- Act cooperatively and courteously with patients, visitors, co-workers, management and clients.
- Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
- Work independently from assigned work queues.
- Maintain confidentiality at all times.
- Maintain a professional attitude.
- Other duties as assigned by the management team
Qualifications
- Completed at least High School education
- With minimum 1 year of US Healthcare Account Receivable/Collections in a BPO setting or environment (claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers)
- Experienced on medical billing/ AR Collections.
- Background in calling insurance (Payer) to verify claim status and payment dispute.
- Must be amenable to work night shifts.
- Must be amenable to work onsite in Ortigas, Pasig.
What's In It For You:
- HMO on day 1 with dependent(s)
- Free Lunch
Job Type: Full-time
Pay: Php25, Php33,000.00 per month
Benefits:
- Health insurance
- Life insurance
Work Location: In person
-
Claim Support
2 weeks ago
Ortigas, Philippines Ardent Paralegal and Business Solutions Inc. Full time $40,000 - $60,000 per yearJob SummaryThe Claims Support Specialist will provide assistance in processing and managing insurance claims. This role does not require advanced qualifications but demands attention to detail, accuracy, and the ability to handle claim-related tasks efficiently. The position is comparable in level to a Medical Records Clerk (MRC) and is vital in ensuring...
-
Medical Coder
2 weeks ago
Ortigas, Philippines Addforce Human Resources Solution Inc. Full time ₱600,000 - ₱700,000 per yearPOSITIONMedical Coder | RN with CPC | WFHWORK SET UP : WFHWORK SCHEDULE: Night Shifting ScheduleSALARY PACKAGE: 60, ,000KINDLY INCLUDE YOUR JOB DESCRIPTION, DUTIES & RESPONSIBILITIES, TOOL, CERTIFICATION AND TRAINING IN YOUR CV FOR PAPER SCREENINGJob Requirements:Position Summary:The Medical Coder will be responsible in conducting research and identifying...
-
Claims Assistant
2 weeks ago
Ortigas, Philippines MEDICARE PLUS, INC. Full time $30,000 - $50,000 per yearJob Summary: The Claims Assistant provides administrative support to the claims department by processing, organizing, and managing claim-related documents and data. They assist claims adjusters and other team members in handling insurance claims efficiently and accurately. The Claims Assistant plays a crucial role in ensuring that claims are processed in a...
-
PHRN Medical Biller
2 weeks ago
Ortigas, Philippines KMC Solutions Full time $40,000 - $80,000 per yearWe are seeking for a PHRN - Medical Biller to join our team. As a Medical Biller, you will play a crucial role in ensuring efficient and accurate billing processes for our clients in the healthcare sector. You will be responsible for reviewing and submitting claims, following up on unpaid claims, and resolving any billing-related issues to maximize...
-
Medical Billing Specialist
5 days ago
Ortigas, Philippines Comrise Full time ₱25,000 - ₱330,000 per yearJob PurposeThe representative is responsible for collections, account follow up, billing and allowance posting for the accounts assigned to them.Duties and ResponsibilitiesFollow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites.Meets and maintains daily productivity/quality standards established in...
-
Medical Billers
4 weeks ago
Ortigas Center, Philippines Eastvantage Full timePosition SnapshotThe Billing Specialist is responsible for ensuring the accurate and timely submission of claims topayers, maintaining compliance with industry standards, and ensuring billing accuracy. This rolefocuses on precise claim preparation, attention to detail, and proper documentation to minimize errorsand maximize clean claim rates. The ideal...
-
Medical Management Resolution Specialist
2 weeks ago
Ortigas, Philippines Visaya Knowledge Process Outsourcing Corporation Full time $30,000 - $50,000 per yearRole: Medical Coders - Medical Management Resolution Specialist About Visaya KPO: Visaya Knowledge Process Outsourcing Corporation is a proudly Filipino organization recognized globally for service excellence, innovation, and a culture of malasakit. We are committed to building long-term partnerships through quality, reliability, and a people-first...
-
Customer Service Representative
3 days ago
Ortigas, Philippines VCC Link, Inc. Full timeJob Description: Respond to inbound and outbound calls, emails, and chats from patients, members, or providers. Provide accurate information about healthcare plans, coverage, claims, billing, authorizations, and medical services. Handle escalations and resolve customer concerns with empathy, accuracy, and professionalism. Qualifications: College...
-
HMO Representative
2 weeks ago
Ortigas, Philippines InLife Health Care Full time $30,000 - $50,000 per yearJOB REQUIREMENTS: Graduate of any 4-year college course, medical allied (preferred). Experience in insurance / HMO and value-adding services preferred. Good communication, coordination, and negotiation skills. With BPO experience handling healthcare account is an advantage but not required. Okay for project-based employment. Work...
-
Healthcare Tech Specialist
3 days ago
Ortigas, Philippines Sapient Global Services Full timeEasy, no-hassle and Fast One-day Hiring process! Earn up to 25k monthly plus more benefits! We are looking for a Healthcare Specialist Representative in our Metro Sites! This is for urgent hiring, don’t miss this opportunity and Apply Now! Responsibilities: • Manage healthcare-related inquiries, claims, and service requests with accuracy and...