RCM - US Healthcare Medical Claims Specialist | Quezon City

6 days ago

Quezon City, National Capital Region, Philippines Optum Full time ₱1,200,000 - ₱2,400,000 per year

Job Qualifications:

  • SHS Graduate or 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
    on-site in Quezon City
    .
  • Experience in a BPO Healthcare Account is required.

Primary Responsibilities:

  • Read contracts for payment disputes.
  • Work on the provider side.
  • Verify claim status and collect unpaid claims from insurance.
  • Process claims payments, manage denials, and track claim statuses.
  • Manage collections for healthcare unpaid claims.
  • Interact with customers to ensure invoice accuracy and resolve claims discrepancies.
  • Provide input on policies, systems, methods, and procedures for premium collection management.
  • Educate customers on online applications for claims and payments.
  • Monitor outstanding balances and ensure clients pay as billed.
  • Prepare invoices and reconcile billing with accounts receivables.
  • Conduct quality assurance and audits of collection activities.
  • Handle documents, emails, and calls related to account processes.
  • Perform accounts receivable collections, follow-up, denial management, claims payment processing, tracking, and appeals for hospital processes.

Your role is critical in providing confidence in the exceptional care we offer to our members, families, facilities, and health professionals. This is an everyday opportunity to do your life's best work.

WHAT WE OFFER

  • Market Competitive Pay Levels
  • Fast Processing No Exam Hiring
  • Retirement Plan
  • Medical Plan (HMO) from Day 1 of employment
  • Dental, Medical, and Optical Reimbursements
  • Life and Disability Insurance
  • Paid Time-Off Benefits
  • Sick Leave Conversion
  • Tuition Fee Reimbursement
  • Employee Assistance Program (EAP)
  • Annual Performance Based Merit Increases
  • Employee Recognition
  • Training and Staff Development
  • Employee Referral Program
  • Employee Volunteerism Opportunity
  • All Mandatory Statutory Benefits

WHO WE ARE

  • Optum
    is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.
  • UnitedHealth Group
    is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.
  • We're a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.
  • As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.
  • We're a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines.
  • Elevate your career with a leading health care company while improving lives.

Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that's dedicated to
Caring. Connecting. Growing together.

  • Medical Biller

    4 days ago

    Quezon City, National Capital Region, Philippines Alliance Global Solutions Full time ₱400,000 - ₱600,000 per year

    Job descriptionA Medical Billing and Payment Specialistis responsible for managing the financial aspects of treatment. Your main role is to ensure that all necessary billing information is accurately entered into the system, that insurance claims are properly filed.Key Responsibilities:Insurance Claims ProcessingAccurately submit insurance claims using...

  • US Registered Nurse

    6 days ago

    Makati City, National Capital Region, Philippines R1 RCM Full time ₱1,500,000 - ₱3,000,000 per year

    US Registered Nurse with active license Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to...

  • Medical Billing Specialist – Collections

    2 weeks ago

    Quezon City, National Capital Region, Philippines Sourcefit Full time $70,000 - $120,000 per year

    Position Summary:The primary responsibility of the Medical Billing Specialist – Collections is to assist our clients in collecting payments from the insurance companies for the medical services rendered to their patients. This includes charge entry and providing exceptional customer service.Job Details:Work from home Monday to Friday | 9:00 PM to...

  • Medical Billing Specialist

    1 week ago

    Quezon City, National Capital Region, Philippines Sourcefit Full time ₱600,000 - ₱800,000 per year

    Position Summary:The Medical Billing Specialist - Collection is a key role within our healthcare team. This position is accountable for monitoring the status of medical claims, thoroughly investigating rejections and denials, and diligently documenting related account activities. The Medical Biller is tasked with the critical responsibility of posting...

  • medical claims associate

    2 weeks ago

    Makati City, National Capital Region, Philippines United Coconut Planters Life Assurance Corp (Cocolife) Full time ₱900,000 - ₱1,200,000 per year

    Position: Medical Claims AssociateLocation: Cocolife Building, Ayala Avenue, Makati CityWork Setup: Onsite Monday - Friday 8am- 5pmJob Summary:We are looking for a detail-oriented and reliable individual to join our team as a CLAIMS ASSOCIATE. The successful candidate will be responsible for the evaluation and prompt processing of medical claims....

  • Outpatient Medical Coder

    4 days ago

    Makati City, National Capital Region, Philippines R1 RCM Full time ₱600,000 - ₱1,200,000 per year

    Qualifications:Must have an active PHRN LicenseMust have an active Medical Coding Certification (CPC, COC, CCS and/or CCS-P)With at least 2+ years of OP (SDS and/or ED – E/M) coding experienceAdvantage will be given to those with Charge Capture/Charge Audit, OP QA or Auditor experienceWith experience in any EMR systems such as Epic, Cerner &...

  • Healthcare Customer Service Representative

    16 hours ago

    Makati City, National Capital Region, Philippines R1 RCM Full time ₱900,000 - ₱1,200,000 per year

    What will you do in this role?You will be responsible for providing expertise and excellent customer service support that meet the needs of our patients by educating them on balance billing, payment processing, available payment arrangement, dispute resolution, collecting accurate insurance information, verifying benefits and eligibility, appointment...

  • Healthcare Claims Accounts Receivable Representative

    3 days ago

    Quezon City, National Capital Region, Philippines Optum, a UnitedHealth Group Company Full time ₱350,000 - ₱550,000 per year

    This function is responsible for Collections for Healthcare unpaid claims. The position in this function interact with customers gathering support data to ensure invoice accuracy and also work through specific claims discrepancies. Provide input to policies, systems, methods, and procedures for the effective management and control of the premium collection...

  • Healthcare Specialist

    2 weeks ago

    Makati City, National Capital Region, Philippines EMAPTA Full time ₱900,000 - ₱1,200,000 per year

    The Medical Records Specialist is responsible for analyzing claims eligible for arbitration. This individual should possess superior communication and computer skills including familiarity, Microsoft Outlook, Word and Excel. This individual will review, analyze and report reimbursement of integrity measures.Job Overview:Employment type: Full-timeSchedule:...

  • Back office Medical Billing Associate

    1 week ago

    Quezon City, National Capital Region, Philippines Med health Connect Outsourcing Inc Full time ₱230,000 - ₱240,000 per year

    Job Title: Pharmacy Services Associate – Accounts Receivable (Healthcare Account)Location: 8F Global One Building, Eastwood City, Libis, Quezon City (100% Onsite)Job Summary:We are seeking a detail-driven and highly organized Pharmacy Services Associate (Accounts Receivable) to support our Healthcare Account team. This role is responsible for overseeing...