Denied Medical Claims Auditor — Improve Denials

Health Business Solutions LLC; Cebu City; On-site; PHP 334,800 - 502,200; Full time

Job summary

A healthcare solutions company based in Cebu City is seeking a qualified candidate for a medical claims auditor role. You will review denied claims, prepare documentation for appeals, and collaborate with clinical and billing teams. The ideal applicant will have a Bachelor's degree in healthcare administration and at least 3 years of relevant experience. Proficiency in coding and compliance with HIPAA regulations is essential. This position offers an opportunity to enhance claims processing efficiency in a supportive environment.

Qualifications

• Minimum of 3 years experience in medical claims, billing, coding, or auditing.
• Knowledge of ICD-10, CPT, and HCPCS coding.
• Ability to work with confidential patient and claims information in compliance with HIPAA.

Responsibilities

• Review denied medical claims to determine reasons for denial.
• Collect and verify supporting documentation for appeals.
• Prepare and submit claim audit packets for review.

Skills

Analytical thinking

Strong written and verbal communication

Time management

Multitasking

Collaboration

Process improvement mindset

Education

Bachelor's degree in healthcare administration or related field

Tools

Microsoft Office Suite

Claims management systems (Epic, Facets, Availity)

Job description

A healthcare solutions company based in Cebu City is seeking a qualified candidate for a medical claims auditor role. You will review denied claims, prepare documentation for appeals, and collaborate with clinical and billing teams. The ideal applicant will have a Bachelor's degree in healthcare administration and at least 3 years of relevant experience. Proficiency in coding and compliance with HIPAA regulations is essential. This position offers an opportunity to enhance claims processing efficiency in a supportive environment.