Insurance Claims Specialist

3 days ago

Taguig, National Capital Region, Philippines Systemantech Full time ₱200,000 - ₱300,000 per year

This role is responsible for timely and accurate

resolution of account receivables either through insurance payment collections, adjustment, or write offs.

This job description will be reviewed periodically and is subject to change by management.

RESPONSIBILITIES:

➢ Performs AR follow-up on assigned accounts taking into account Timely Filing Limits

set by the payer.

➢ Submits adjustments or write-off requests for approval to resolve outstanding account

balances.

➢ Submits medical record packets for submission to the payer for claims reprocessing,

reconsideration or appeal requests.

➢ Receives inbound calls/ call backs from payers/insurances regarding accounts that

they are actively working on.

➢ Resolves claim rejections accordingly in order to release a clean claim to the payer.

➢ Responds to e-mail inquiries from different departments regarding pending insurance

balances or claim denials.

➢ Maintains accurate and detailed notes/documentation in applicable systems.

➢ Keeps Supervisor and/or Manager informed of system issues.

➢ Observes legal and ethical guidelines for safeguarding patient and company

confidentiality (HIPAA).

➢ Other duties as assigned.

BASIC QUALIFICATIONS | EDUCATION:

➢ Completed at least 2 years in College or with an Associate or Bachelor's Degree

➢ Excellent oral and written communication skills

➢ Thorough understanding of the US Healthcare Insurance claims

PREFERRED QUALIFICATIONS:

➢ Proficient Medicare and solid general payer knowledge

➢ Has the ability to read and interpret explanation of benefits

➢ Basic Excel, Word and Outlook experience required

➢ Typing using computer keyboards, 10-key pads and calculators

➢ Strong Computer/Software Skills

➢ Detail-oriented

➢ Typing speed of 35 wpm

➢ Occasional weekend work may be required

➢ Must be flexible to work on a night shift (between 6pm to 10am) Philippine Standard

Time.

➢ Must be amenable to work on Overtime or during Rest Days when business requests

for additional (paid) hours

COMPETENCIES:

➢ Internal – At least 1 year tenure in ACH

➢ External – 1 year of experience in Healthcare Insurance Collections and/or

Correspondence

Job Type: Full-time

Pay: Up to Php30,000.00 per month

Benefits:

  • Additional leave
  • Company events
  • Health insurance
  • Life insurance
  • Opportunities for promotion
  • Paid training
  • Promotion to permanent employee

Ability to commute/relocate:

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

Application Question(s):

  • Please provide your Viber number for faster communication.
  • START ASAP?

Experience:

  • Healthcare Insurance Collections and/or Correspondence: 1 year (Required)

Location:

  • Taguig (Preferred)

Work Location: In person

  • Associate - Insurance Claims

    1 week ago

    Taguig, National Capital Region, Philippines Principal Global Services Full time ₱300,000 - ₱450,000 per year

    ResponsibilitiesDescription % of Time SpentAnalyze and process information received/not received to decide if claim moves to IGO or if claim follows our NIGO process where a determination is made on the claim. 25%Communicate, both written and verbally with claimants, employers, beneficiaries, and medical providers regarding claim status and to obtain/collect...

  • Claims Examiner

    1 week ago

    Taguig, National Capital Region, Philippines Curran Daly + Associates Full time ₱1,200,000 - ₱2,400,000 per year

    We are seeking aPersonal Injury Claims Managerto lead, strategize, and optimize the firm's Personal Injury (PI) claims operations across multiple teams. This role plays a critical part in driving case efficiency, ensuring compliance with U.S. PI standards, and enhancing overall client experience and claim outcomes.The ideal candidate brings deep expertise in...

  • Healthcare Claims Specialist

    2 weeks ago

    Taguig, National Capital Region, Philippines Systemantech Full time ₱300,000 per year

    This role is responsible for timely and accurateresolution of account receivables either through insurance payment collections, adjustment, or write offs.This job description will be reviewed periodically and is subject to change by management.RESPONSIBILITIES:➢ Performs AR follow-up on assigned accounts taking into account Timely Filing Limitsset by the...

  • Medical Claims Specialist

    2 weeks ago

    Taguig, National Capital Region, Philippines Optum Full time ₱1,500,000 - ₱3,000,000 per year

    Job Qualifications: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 ...

  • Personal Lines/Claims Insurance Associate

    4 days ago

    Taguig, National Capital Region, Philippines ATOS Information Technology Inc. Full time ₱900,000 - ₱1,200,000 per year

    About AtosAtos is a global leader in digital transformation with c. 78,000 employees and annual revenue of c. € 10 billion. European number one in cybersecurity, cloud and high-performance computing, the Group provides tailored end-to-end solutions for all industries in 68 countries. A pioneer in decarbonization services and products, Atos is committed to...

  • Insurance Head

    4 days ago

    Taguig, National Capital Region, Philippines Filinvest Group Full time ₱1,200,000 - ₱2,400,000 per year

    The Insurance Head is responsible for setting the insurance strategy and for delivering advice and support on all matters related to insurance. The Insurance Head is the company insurance expert and as such directs and guides the businesses in such matters. They are responsible for continually reviewing the companies risk profiles to ensure the insurance...

  • Insurance Manager

    4 days ago

    Taguig, National Capital Region, Philippines Filinvest Group Full time ₱600,000 - ₱1,800,000 per year

    The Insurance Manager is responsible for executing the insurance strategy and for delivering advice and support on all matters related to insurance. The Insurance Manager acts as the company insurance expert and as such directs and guides the businesses in such matters. Responsible for continually reviewing the companies risk profiles to ensure the...

  • wfh - urgent hiring: part-time insurance agents (pru life uk)

    1 week ago

    Taguig, National Capital Region, Philippines Cyrene Insurance Agency Full time ₱150,000 - ₱250,000 per year

    Handle group insurance packages and build partnerships with companies.Responsibilities:Present corporate insurance benefits to businesses.Coordinate with HR and management teams.Manage group accounts and claims processing.Qualifications:Fresh Graduates welcome to apply.Excellent negotiation skills is a plusOrganized and detail-oriented.Willing to undergo...

  • Claims Representative

    2 weeks ago

    Taguig, National Capital Region, Philippines Fashion Accessories Shop Miyam Full time ₱900,000 - ₱1,200,000 per year

    About the roleFashion Accessories Shop Miyam' is seeking a talented Claims Representative (Healthcare Account) to join our team in Taguig City, Metro Manila. This is a full-time, hybrid role, which means you'll have the flexibility to work both in the office and remotely. As a Claims Representative, you'll be an integral part of our customer service team,...

  • Vendor Debits – Claims

    3 days ago

    Taguig, National Capital Region, Philippines PRO INTEGRATE WORLD IT CONSULTING INC. Full time ₱240,000 - ₱300,000 per year

    Join a fast-paced environment managing complex reconciliations and claims.Handle high-volume claims processing and dispute resolutionManage escalations and exception casesAnalyze and reconcile large datasetsQualification: At least 1.5–7 years relevant experienceJob Types: Full-time, PermanentPay: Php20, Php25,000.00 per monthBenefits:Health...