Medical Claims Analyst – Accounts Receivable
2 days ago
Job Summary
We are looking for experienced
Medical Claims Analysts – Accounts Receivable (AR)
to join our growing healthcare operations team. The role involves handling provider billing, performing AR collections, and ensuring timely and accurate claims resolution. The ideal candidate has solid experience in healthcare revenue cycle management, exceptional communication skills, and a strong understanding of medical claims processes.
Key Responsibilities
- Review, analyze, and process medical claims submitted on CMS-1500 and UB-04 forms.
- Perform end-to-end Accounts Receivable (AR) follow-up to ensure claims are paid promptly.
- Contact insurance companies via outbound calls to resolve claim denials, underpayments, and rejections.
- Interpret Explanation of Benefits (EOBs) to identify payment discrepancies and determine appropriate actions.
- Collaborate with internal teams and clients to improve claim resolution processes and reduce aging AR.
Qualifications
- With minimum 1 year of US Healthcare Account Receivable/Collections in a BPO setting or environment
(claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers) - Above-average communication skills (verbal and written).
- Willing to make outbound calls to insurance carriers.
- Knowledge of key healthcare and insurance terminologies, including copay, coinsurance, and deductibles.
- Strong understanding of EOB interpretation and familiarity with CMS-1500 and UB-04 claim forms.
- Must be amenable to work night shifts.
- Must be amenable to work onsite in Ortigas, Pasig.
Benefits:
- Day 1 HMO with 2 of your dependents covered for FREE
- Free Lunch Daily
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