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Medical Claims Specialist

Location: Philippines
Job Category: Healthcare

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 and Requirements

• 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.