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Medical Claims Specialist

Responsibilities

  • Contact patients regarding Third Party Liability (TPL) or Coordination of Benefits
  • (COB) forms that have not been returned.
  • Contact insurance payers regarding missing recoupment details on EFT payments
  • Submit Updated W9 to insurance providers as needed.
  • Contact patients if credit card information received via mail is unreadable or if the
  • payments didn’t go through.
  • Follow up with private payers and workers’ compensation to confirm claim receipt.
  • Uphold confidentiality and ensure compliance with all legal requirements.
  • Complete all assigned training within specified timeframes.

Qualifications

  • Demonstrates effective multitasking skills by managing multiple scenarios simultaneously while diligently researching and reviewing patient records.
  • Meticulous attention to detail ensuring that all documentation and processes are meticulously accurate and compliant.
  • Ability to maintain a friendly and outgoing demeanor, fostering positive interactions with patients and colleagues alike to create a welcoming environment.
  • Strong organizational skills and proficiency in general office tasks, enabling efficient management of workflows and prioritization of responsibilities.
  • Clear and coherent in both verbal and written communication skills to effectively convey information and instructions to patients and team members.
  • Strong critical thinking and problem-solving abilities to interpret information and address issues promptly, ensuring effective resolutions.
  • Willingness to take on additional responsibilities as needed, collaborating effectively across departments to support overall organizational goals.

Screening Criteria

  • Minimum of one (1) year of customer service or billing experience
  • Must have a stable employment history.
Location: Philippines
Job Category: Healthcare
Work Setup: WFH Permanent