Claims Processor

4 days ago


Manila, National Capital Region, Philippines Swift-up Full time ₱900,000 - ₱1,200,000 per year

Short Description:

  • Review and verify the accuracy and completeness of submitted medical claims, including patient information, provider details, services rendered, and billed amounts.
  • Assess the coding accuracy of diagnoses, procedures, and services according to industry-standard code sets such as ICD-10, CPT, and HCPCS.
  • Determine the eligibility of claims based on contract terms, insurance coverage, and medical necessity criteria. Process claims for payment or denial accordingly.
  • valuate supporting documentation, such as medical records and invoices, to validate the services billed and ensure compliance with coding guidelines.
  • Investigate and resolve discrepancies or discrepancies in claim submissions, collaborating with internal teams, providers, and insurers as needed.

Minimum Requirements:

  • Minimum of 2 years' experience
  • Above average english communication skills

NOTE: This role is Dayshift and requires 15 days a year on-site.


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