Medical Management Resolution Specialist

2 days ago

Ortigas, Philippines Visaya Knowledge Process Outsourcing Corporation Full time $30,000 - $50,000 per year

Role: Medical Coders - Medical Management Resolution Specialist

About Visaya KPO:
Visaya Knowledge Process Outsourcing Corporation is a proudly Filipino organization recognized globally for service excellence, innovation, and a culture of malasakit. We are committed to building long-term partnerships through quality, reliability, and a people-first approach.

Role Overview:
We are looking for a detail-oriented Medical Management Resolution Specialist to join our team. The ideal candidate will have experience in medical coding within the US healthcare system, whether certified or non-certified, and a strong background in medical management resolution.

Key Responsibilities

  • Review and analyze medical records, claims, and documentation to resolve medical management and coding issues.

  • Collaborate with healthcare providers, coders, and payers to clarify documentation and ensure accurate coding and claim resolution.

  • Assist in resolving denials, discrepancies, and other issues related to medical management and billing.

  • Maintain detailed records of case resolutions and communicate updates to relevant stakeholders.

  • Support process improvement initiatives to enhance accuracy and efficiency in medical management resolution.

  • Stay current with coding guidelines, payer policies, and healthcare regulations.

  • Ensure compliance with company policies and regulatory standards.

Qualifications:

  • College level education.

  • Open to Certified Medical Coders or Non-Certified Experienced Medical Coders with US healthcare experience.

  • Minimum of 2 years related experience in medical management resolution or medical coding.

  • Strong understanding of medical coding systems and healthcare terminology.

  • Excellent problem-solving, communication, and analytical skills.

  • Willingness to work onsite in Ortigas and on a night shift schedule.

  • Detail-oriented with the ability to manage multiple cases efficiently.

Perks and Benefits:

  • 15% Night Differential

  • HMO coverage after 30 days of employment (with option to add up to 2 dependents)

  • Retirement Benefits

  • 24 Leave Credits per year (convertible to cash)

  • Wholistic Employee Wellness Program

Why Join Visaya KPO?

  • Be part of a multi-awarded, 100% Filipino-owned company recognized for its leadership and innovation in the outsourcing industry1.

  • Work in a culture that values professional growth, employee well-being, and long-term partnerships.

  • Enjoy industry-leading benefits and a supportive, inclusive environment.

Visaya KPO is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

#visayajobs

Job Type: Full-time

Benefits:

  • Company Christmas gift

  • Company events

  • Health insurance

  • Opportunities for promotion

  • Paid training

  • Promotion to permanent employee

Schedule:

  • 8 hour shift

  • Monday to Friday

  • Night shift

Supplemental Pay:

  • 13th month salary

  • Overtime pay

Ability to commute/relocate:

  • Ortigas: Reliably commute or planning to relocate before starting work (Required)

Experience:

  • US Medical Coding: 2 years (Preferred)

License/Certification:

  • Medical Coding license/certification (Preferred)

Work Location: In person

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