Medical Collections Specialist

4 days ago

Carmen Misamis Oriental, Philippines Clinovation Corp. Full time $30,000 - $60,000 per year
Job Summary

Clinovation Corp, a call center and business associate of a US-based medical group, is looking for a Medical Collections Specialist to join our Revenue Cycle Management team. This role focuses on accurate claim repricing, payer negotiation, and collections follow-ups to ensure maximum reimbursement. The ideal candidate has a solid background in medical billing, deep understanding of payer rules, and sharp attention to detail.


Key Responsibilities

Repricing & Collections

  • Review medical claims for accuracy and ensure they follow payer contracts and fee schedules.
  • Identify reimbursement discrepancies and initiate corrective actions such as adjustments or appeals.
  • Monitor underpaid or incorrectly paid claims and resolve issues through follow-up and negotiation.
  • Coordinate with insurance payers to negotiate payment rates for out-of-network claims when applicable.
  • Stay updated on payer-specific rules, regulations, and fee schedule updates.

Revenue Optimization

  • Analyze collection and repricing trends to identify workflow improvement opportunities.
  • Collaborate with the Billing Manager to refine claim management policies.
  • Develop strategies to minimize denials and maximize reimbursement.

Documentation & Communication

  • Maintain detailed records of payer communications, adjustments, and resolutions.
  • Prepare and distribute reports summarizing collection performance, trends, and outstanding issues.
  • Coordinate with US-based teams and payers to resolve disputes professionally.

Compliance

  • Ensure all repricing and collection activities comply with federal, state, and payer regulations, including HIPAA.
  • Conduct periodic audits of repriced claims for accuracy and compliance.

Qualifications

Education & Experience

  • High school diploma or equivalent required; associate's or bachelor's degree preferred.
  • Minimum of 2–3 years of experience in medical billing, collections, or payer negotiations, ideally in a provider-side or healthcare BPO setting.

Skills & Competencies

  • Proficiency in medical billing systems (e.g., Kareo, AdvancedMD, or similar).
  • Strong understanding of CPT and ICD-10 coding and payer fee schedules.
  • Excellent negotiation and problem-solving skills.
  • Strong analytical ability and keen attention to detail.
  • Effective verbal and written communication skills.
  • Ability to multitask and meet deadlines in a fast-paced environment.

Certifications (Preferred but Not Required)

  • Certified Professional Biller (CPB) or Certified Professional Coder (CPC).

What We Offer
  • Company-covered government contributions - no deductions on salary (SSS, PhilHealth, Pag-IBIG).
  • Paid time off and holiday pay.
  • Opportunities for upskilling and career advancement.

Equal Opportunity Employer

Clinovation Corp is an equal opportunity employer. We celebrate diversity and are committed to maintaining an inclusive, collaborative workplace.

  • Medical Sales Representative

    5 days ago

    , Misamis Oriental, Philippines Medical Trends & Technologies,(MEDT2EK) Inc. Full time

    MEDTEK is a fast-growing company in the heart of Paranaque. We carry Point of Care, Rapid and Automation diagnostic kits and machines of international standard and reliability from leading international manufacturers through a vast distribution network nationwide. MEDTEK is a diagnostic company established in the Philippines since 2003 and an affiliate...

  • Negotiations and Repricing Specialist

    3 weeks ago

    , Misamis Oriental, Philippines Clinovation Corp. Full time

    Key Responsibilities Repricing & Collections Review medical claims for accuracy and ensure they are priced according to payer contracts and fee schedules. Identify discrepancies in reimbursement and initiate corrective actions, such as adjustments or appeals. Monitor underpaid or incorrectly paid claims and resolve issues through follow-up and negotiation....

  • Administrative Specialist/Assistant

    2 weeks ago

    , Misamis Oriental, Philippines LOF Enterprises OPC Full time

    Administrative Specialist/Assistant LOF Enterprises OPC Salary: ₱10-15K (Monthly) • On-site • Misamis Oriental Job Type: Full-time • Fresh Graduate/Student Job Description Will help admin manager to sort employee files Will also help with payroll if deemed necessary Should be willing to learn Should also know basic accounting Location Cagayan de Oro...

  • Medical Sales Representative-Specialist

    5 days ago

    Misamis Occidental, Philippines East Lane Corporation Full time

    As a Medical Sales Specialist, you will be responsible for promoting and selling our cutting-edge medical products to healthcare professionals. Your primary duties will include: Developing and implementing sales strategies to achieve targets and maximize revenue. Building and maintaining strong relationships with key decision-makers in hospitals, clinics,...

  • INVENTORY SPECIALIST

    5 days ago

    , Misamis Oriental, Philippines GAMA FOODS CORPORATION Full time

    Position: Inventory Specialist - Feedmill Area of Assignment: Baloy, Tablon, Cagayan de Oro City Full Time Position - Shifting Schedule Job Summary: We are looking for an Inventory Specialist to manage and ensure accurate inventory control in our Feedmill Plant. The ideal candidate must have strong attention to detail, excellent organizational skills, and...

  • HR SPECIALIST

    4 weeks ago

    , Misamis Oriental, Philippines GAMA FOODS CORPORATION Full time

    Position: HR Specialist - PlantLocation: Tablon, Cagayan de OroWork Schedule: Monday to Friday, 8:00 AM 6:00 PM Job Summary We are looking for dedicated HR Specialists to join our growing team. The HR Specialist for Plant will focus on employee relations, timekeeping, and manpower complement for our Dressing Plant operations, ensuring smooth daily HR support...

  • Purchasing Specialist

    5 days ago

    , Misamis Oriental, Philippines Gama Foods Corporation Full time

    Position: Purchasing Specialist – Services Schedule: Monday to Friday, Full-time Location: Baloy, Tablon, Cagayan de Oro Job Summary We are looking for a proactive and detail-oriented Purchasing Specialist – Services to join our team. This role is responsible for procuring service-related requirements such as trucking, freight forwarding, and other...

  • TAX SPECIALIST

    5 days ago

    , Misamis Oriental, Philippines GAMA FOODS CORPORATION Full time

    Position: Tax Specialist Location: Baloy, Tablon, Cagayan de Oro Work Schedule: Monday to Friday Job Summary: We are looking for a detail-oriented Tax Specialist who will be responsible for tax compliance, accounting tasks, and accurate recording of transactions. The ideal candidate should have a strong background in accounting and taxation, and must be...

  • Administrative Specialist/Assistant

    2 weeks ago

    , Misamis Oriental, Philippines Coldwave Refrigeration Services Full time

    Administrative Specialist/Assistant Coldwave Refrigeration Services ₱5-10K (Monthly) On-site - Misamis Oriental No Exp Required Edu not required Full-time Job Description Will help manager to sort employee profiles Will also assist in the payroll Should be bachelors degree holder in business administration Working Location Cagayan de Oro, Misamis Oriental,...

  • PARALEGAL AND COMPLIANCE SPECIALIST

    3 weeks ago

    , Misamis Oriental, Philippines GAMA FOODS CORPORATION Full time

    Position Paralegal and Compliance Specialist Location Cagayan de Oro Employment Type Full-Time Job Summary We are looking for a Paralegal and Compliance Specialist who will assist in managing the company’s legal documentation and regulatory compliance requirements. The role is crucial in ensuring that contracts, permits, and legal titles are processed and...