Customer Service Representative (Medical Claims)

Job Description:
Join a dynamic team and make a meaningful impact in the healthcare industry. As a Medical Claims Analyst, you will play a key role in ensuring accurate claims processing while advancing your career in a supportive and innovative environment. Enjoy competitive benefits from day one, ongoing professional development, and the satisfaction of helping others every day.

Benefits Include:

• 8-Hour Shifts, Fixed Weekends Off
• Day 1 HMO coverage including 2 dependents
• Medical Cash Allowance
• Rice and Clothing Allowances
• Free Lunch Daily
• Paid Time Off
• Training and Staff Development
• Employee Engagement Activities
• Opportunities for Internal Mobility

Job Purpose:
The Medical Claims Analyst is responsible for collections, account follow-up, billing, and allowance posting for assigned accounts.

Key Duties and Responsibilities:

• Follow-up with payers to ensure timely resolution of outstanding claims via phone, email, fax, or websites
• Meet daily productivity and quality standards
• Use workflow systems, client host systems, and other tools to collect payments and resolve accounts
• Adhere to client/team policies and procedures
• Understand timely filing deadlines for each payer
• Research payer-specific billing guidelines as needed
• Analyze and resolve issues causing payment delays and reduce denials
• Initiate appeals when necessary and ensure accuracy in documentation
• Identify and correct medical billing errors
• Assist with special A/R projects as needed
• Maintain confidentiality and professional conduct at all times
• Comply with HIPAA and Information Security policies

Qualifications:

• At least a High School diploma
• Minimum 1 year of healthcare Accounts Receivable/Collections experience in a BPO environment
• Experience in medical billing/AR collections and calling insurance payers to verify claims
• Strong interpersonal, communication, and problem-solving skills
• High integrity, dependability, and results-oriented mindset
• Excellent written and verbal communication skills
• Gracious and professional customer service demeanor

Working Conditions:

• Night shift availability required
• Must be willing to work onsite
• Physical demands: occasional movement, sitting, manual tasks, operating office equipment, extending arms, kneeling, talking, and hearing
• Mental demands: follow directions, collaborate, handle stress
• Work environment: generally minimal noise levels

Job Types: Full-time, Permanent

Pay: Up to Php35,000.00 per month

Benefits:

• Discounted lunch
• Health insurance

Application Question(s):

• Are you amenable to work onsite in a night shift in Pasig?
• How much are your salary expectations?

Experience:

• Healthcare: 1 year (Required)
• Medical Billing, AR Follow ups, Denials and Appeals: 1 year (Required)
• Calling insurance (Payer) : 1 year (Required)
• Healthcare Account Receivable/Collections: 1 year (Required)

Work Location: In person