Medical Claims Analyst
5 days ago
Medical Claims Analyst
Shift: Night, M-F, 9pm-5am
Work Setup: Onsite (Ortigas, Pasig)
About the Role:
Our client is looking for a highly motivated and detail-oriented Medical Claims Analyst to join our team In this role, you will be responsible for the collection, account follow-up, billing, and allowance posting for assigned accounts, ensuring timely resolution of all outstanding claims.
Key Responsibilities:
- Follow up with payers to resolve outstanding claims via phone, emails, fax, or websites.
- Meet daily productivity and quality standards as set by departmental policies.
- Use workflow systems, client host systems, and other tools for claims payment collection and resolution.
- Adhere to policies and procedures while ensuring timely filing deadlines are met.
- Research payer-specific billing guidelines as needed.
- Identify and resolve payment delays, trends, and issues to reduce denials.
- Initiate appeals and correct billing errors when necessary.
- Understand under/overpayments and credit balance processes.
- Assist with special A/R projects as needed.
- Maintain patient confidentiality and adhere to HIPAA standards.
Qualifications:
- Completed at least High School (Senior High) education.
- Minimum of 1 year experience in Healthcare Accounts Receivable/Collections in a BPO setting or environment (including claims payment processing, claims status, medical billing, AR follow-ups, denials, and appeals).
- Experienced under Provider side
- Familiarity with Denial management (reasons of denials)
- AR follow up experience
- Familiar with Explanation of Benefits, Copay, Coinsurance and Deductibles.
- Experience processing billing and payments
Job Type: Full-time
Pay: Up to Php33,000.00 per month
Benefits:
- Health insurance
- Opportunities for promotion
Application Question(s):
- Please share your active Viber number and best time to call you.
- What is your expected salary for this role?
- This role requires working the night shift and being onsite for 5 days a week. Are you comfortable and amenable with these requirements?
Experience:
- US Healthcare (claims, denials, medical billing, etc): 1 year (Required)
Work Location: In person
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