Medical Claims Specialist

2 days ago

Taguig, National Capital Region, Philippines IQ BackOffice Full time ₱400,000 - ₱600,000 per year

The
Medical Claims Specialist
will be responsible and knowledgeable in managing patient interactions regarding patient financial matters such as billing inquires, explaining balances, assisting with payment options, collecting insurance details, verifying coverage, enrollment in Financial Assistance Programs, and updating patient preferences and following up on document requests with patients.

Core Responsibilities/requirements:

  • Works inbound and outbound call queues/ emails, effectively communicating with patients to notify of balances and the options/process of making payments
  • Enters notes into appropriate databases to record status of assigned patient activity, audit purposes, and inter-departmental communications.
  • Read and interpret and EOB Explanation of Benefits
  • Meet quality assurance standards to ensure a high-quality patient experience minimizing friction and poor sentiment and maximizing satisfaction.
  • Retain and apply multiple aspects of client requirements policy and procedures
  • Communicate with team or lead any issues or concerns
  • Work assigned schedule and maintain flexibility regarding schedule changes to assist team in meeting SLAs and minimizing call and email wait/response time.
  • Ability to answer questions, escalate when necessary
  • Maintain professional control, etiquette, and patient advocacy in all communications – verbal, written, and video.
  • Confidence in ability to ask for payment of balances owed by patient
  • All other duties as assigned.

Education / Experience:

  • Excellent written and verbal communication skills
  • Excellent customer service skills
  • Proficiency in EMR systems, Excel, and Outlook
  • Self-motivated and adaptable to coaching environment
  • Positive attitude and team oriented
  • Knowledge of Medical or Dental billing experience a plus

  • ASAP US Medical Claims

    4 days ago

    Taguig, National Capital Region, Philippines Optum, a UnitedHealth Group Company Full time ₱1,200,000 - ₱2,400,000 per year

    Job Qualifications:Completed at least 2 years of college.Minimum 12 months experience in Healthcare Account Receivable/Collections in a BPO setting.Familiarity with UB Claims and UB04 forms.Experience in medical billing/AR collections.Background in calling insurance (Payer) for claim status and payment disputes.Familiar with EPIC SYSTEM.Willing to work...

  • Claims Specialist

    9 hours ago

    Taguig, National Capital Region, Philippines WHR Global Consulting Full time ₱104,000 - ₱130,878 per year

    Position : Claims Assistant (Non-motor Insurance)Location : Alabang, Muntinlupa CitySetup : OnsiteSchedule : Day ShiftQualifications:Graduate of any 4-year bachelor's degree.2 – 4 years of experience in Non-Motor Claims or prior experience in a claims department or working with insurance claims is a significant advantage.Experience in handling...

  • Medical Billing

    4 weeks ago

    Taguig, National Capital Region, Philippines HR TechX Corp. Full time

    Medical Billing & Claims CSR I Revenue Cycle Management SpecialistJoin to apply for the Medical Billing & Claims CSR I Revenue Cycle Management Specialist role at HR TechX Corp.OverviewThe RCM Senior Associate is responsible for overseeing a broad range of duties within the revenue cycle management process, ensuring accurate and timely claims and billing...

  • Claims SMEs

    4 days ago

    Taguig, National Capital Region, Philippines UST Full time ₱1,200,000 - ₱1,800,000 per year

    Process new claims or modifies existing claims according to the appropriate and applicable actionAnalyze claims to determine appropriate action to approve or deny a claim for paymentDetermine accurate payment criteria for clearing pending claims based on defined policies and proceduresResearch claims edits to determine appropriate benefit application...

  • Claims Director

    3 weeks ago

    Taguig, National Capital Region, Philippines AIA Hong Kong and Macau Full time

    About the RoleResponsible for determining the validity and authorising settlement of insurance claims.Roles and Responsibilities:Assess and settle insurance claims arising from policies in force.Make recommendations and guidelines for claims processing.Liaise with solicitors and third parties during investigation and negotiation to serve the best interest of...

  • Associate - Accidental Claims Analyst

    2 weeks ago

    Taguig, National Capital Region, Philippines Principal Global Services Full time ₱400,000 - ₱800,000 per year

    ResponsibilitiesAs an Accident ClaimsAnalystIn this fast-paced environment, every single day offers new challenges and the ability to use excellent analytical, multitasking, prioritization, and interpersonal skills to assist with clients' Accident Claims.Acquire, analyze, and investigate medical, financial and contractual information to make effective and...

  • Associate - STD/Pregnancy Claims Analyst

    4 days ago

    Taguig, National Capital Region, Philippines Principal Global Services Full time $40,000 - $60,000 per year

    ResponsibilitiesAs aShort Term Disability Claims AnalystIn this fast-paced environment, every single day offers new challenges and the ability to use excellent analytical, multitasking, prioritization, and interpersonal skills to assist with clients' short-term disability claims - all during a time in which they may be facing major changes in life.Here are a...

  • Medical Biller

    4 days ago

    Taguig, National Capital Region, Philippines PM Consulting Full time ₱250,000 - ₱500,000 per year

    URGENTWe are hiring for an experienced Medical Biller to join our growing U.S. healthcare team. In this role, you will manage the end-to-end Revenue Cycle Management process, ensuring timely and accurate claims submission, payment posting, AR follow-up, and denial management for our U.S. clients.This is a great opportunity for professionals with a solid...

  • Accounts Receivable Specialist

    4 weeks ago

    Taguig, National Capital Region, Philippines IQ BackOffice Full time

    OverviewAccounts Receivable Specialist (Medical Biller) | Voice | OnsiteWe are hiring an Accounts Receivable Specialist (Medical Biller) with a strong background in Accounts Receivable voice collections to join our growing team. This role involves a combination of medical billing, claims submission, and collections support to ensure accurate and timely...

  • Associate - STD/Pregnancy Claims Analyst (PH Registered Nurse)

    4 days ago

    Taguig, National Capital Region, Philippines Principal Global Services Full time $104,000 - $130,878 per year

    ResponsibilitiesAcquire, analyze, and investigate medical, financial and contractual information to make effective and timely claim decisions.Connect with employers, employees and medical providers via phone, email, text, and letters.Provide customers with updates regarding medical conditions, restrictions & limitations, job duties, group short term...