Medical Claims and Referrals Specialist

Location: San Juan City, Philippines (On-Site Only)

Job Type: Full-time, Night Shift

Experience Level: Entry to Mid-Level (1+ years experience preferred)

The Opportunity

We are seeking a highly organized, detail-oriented, and customer-focused Medical Claims and Referrals Specialist to join our essential support team in San Juan City.

In this role, you will play a crucial part in ensuring a seamless patient journey by meticulously managing records, appointment scheduling, and proactive patient communication. The ideal candidate possesses strong problem-solving skills and the ability to handle administrative tasks efficiently within a dynamic, fast-paced night shift environment. You will be instrumental in building positive patient relationships and maintaining the accuracy of our records.

We welcome candidates with prior customer service experience. We are also open to new college graduates with an education and foundation in medical terminology.

Key Responsibilities

As a Medical Claims and Referrals Specialist, your primary focus will be on organization, patient follow-up, and administrative accuracy:

• Patient Record Management: Organize and maintain accurate, up-to-date patient records, documentation, and schedules within the system.
• Appointment Coordination: Manage patient appointments, including following up on missed appointments and sending timely reminders to prevent scheduling gaps.
• Administrative Support: Apply problem-solving skills to address and effectively resolve operational or scheduling issues as they arise.
• Patient Relations: Build and maintain strong, professional relationships with patients and internal colleagues.
• Adaptability: Quickly adapt to changing priorities, new challenges, and evolving client protocols.

What You'll Need to Succeed: Required Skills & Experience

• Communication: Excellent communication skills, both oral and written, essential for clear patient and internal team interactions.
• Language Fluency: Must be fully fluent in English (written and verbal communication required). Spanish fluency is a valued bonus.
• Availability: Must be willing and able to work a full-time, mandatory night shift schedule.
• Work Location: Must be able to reliably commute to our on-site facility in San Juan City (this is an on-site only position).
• Organizational Skills: Strong organizational skills and exceptional attention to detail.
• Work Ethic: Proven ability to handle and prioritize multiple tasks effectively, work independently, and contribute positively to a team environment.
• Aptitude: Aptitude to learn quickly in a fast-paced environment.
• Technical Proficiency: Basic computer proficiency, including Microsoft Office Suite (Word, Excel, Outlook) and Google Workspace (Docs, Sheets, Drive).
• Typing Speed: Minimum typing speed of 40 words per minute (WPM).
• Experience: Experience in customer service calls is preferred. One year of experience as a Claims Specialist is a plus.

Education & Knowledge

• Medical Background: Minimum of 1 year of completed study in any medical course or equivalent is required.
• Terminology: Prior knowledge of healthcare terminology is helpful.
• Clerical Experience: Clerical or administrative experience is a plus.

Benefits & Perks

We offer a competitive compensation package designed to support your career and well-being:

• Fixed Weekend Off schedule.
• Competitive salary with performance-based increases and bonuses.
• Night differential pay and regularization.
• Perfect attendance bonus.
• Comprehensive HMO with provisions for dependents.
• Paid vacation leave (VL), sick leave (SL), regular, and special holidays.
• Strong career growth and promotion opportunities.
• Dynamic work environment with team-building activities and company events.
• Complimentary daily drinks.

Job Type: Full-time

Projected Total Compensation: Php15, Php23,000.00 per month

Work Location: In person