Medical Claims Analyst

Med-Metrix; Pasig; On-site; PHP 245,520 - 334,800; Full time

Benefits offered by this job

8-Hour Shifts, Fixed Weekends Off

Day 1 HMO with 2 dependents covered

Group Life Insurance

Medical Cash Allowance

Rice Allowance

Clothing Allowance

Free Lunch Daily

Paid Time Off

Training and Staff Development

Employee Engagement Activities

Job summary

A healthcare company in Pasig is hiring a Medical Claims Analyst to facilitate accurate claims processing. Candidates should have at least a high school diploma and a year of experience in healthcare account receivables in a BPO environment. The role requires excellent communication and problem-solving skills, as well as strong interpersonal abilities. Benefits include Day 1 Health Maintenance Organization coverage, fixed weekends off, and numerous allowances including meals and clothing.

Qualifications

• Completed at least High School education.
• Minimum 1 year of Healthcare Account Receivable/Collections.
• Experienced in medical billing and AR Collections.

Responsibilities

• Follow-up with payers to resolve outstanding claims.
• Analyze and resolve issues causing payment delays.
• Maintain confidentiality and professional attitude.

Skills

Healthcare Account Receivable experience

Medical billing expertise

Interpersonal skills

Problem-solving skills

Communication skills

Education

High School education

Job description

Join our dynamic team and make a meaningful impact in the healthcare industry. You\'ll play a pivotal role in ensuring accurate claims processing while advancing your career in a supportive and innovative environment. Enjoy competitive benefits upon hire, ongoing professional development, and the satisfaction of helping others every day. Take the next step in your career with Med-Metrix!

Benefits

• 8-Hour Shifts, Fixed Weekends Off
• Day 1 HMO with 2 of your dependents covered for FREE
• Group Life Insurance
• Medical Cash Allowance
• Rice Allowance
• Clothing Allowance
• Holiday Gift
• Bereavement Assistance
• 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 the accounts assigned to them.

Duties And Responsibilities

• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
• Meets and maintains daily productivity/quality standards established in departmental policies
• Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
• Adheres to the policies and procedures established for the client/team
• Knowledge of timely filing deadlines for each designated payer
• Performs research regarding payer specific billing guidelines as needed
• Ability to analyze, identify and resolve issues causing payer payment delays
• Ability to analyze, identify and trend claims issues to proactively reduce denials
• Communicates to management any issues and/or trends identified
• Initiate appeals when necessary
• Ability to identify and correct medical billing errors
• Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
• Understanding of under or over payments and credit balance processes
• Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required
• Act cooperatively and courteously with patients, visitors, co-workers, management and clients
• Work independently from assigned work queues
• Maintain confidentiality at all times
• Maintain a professional attitude
• Other duties as assigned by the management team
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Understand and comply with Information Security and HIPAA policies and procedures at all times
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualifications

• Completed at least High School education
• Minimum 1 year of Healthcare Account Receivable/Collections in a BPO setting or environment (claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers)
• Experienced on medical billing/ AR Collections
• Background in calling insurance (Payer) to verify claim status and payment dispute
• Strong interpersonal skills, ability to communicate well at all levels of the organization
• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
• High level of integrity and dependability with a strong sense of urgency and results oriented
• Excellent written and verbal communication skills required
• Gracious and welcoming personality for customer service interaction

Working Conditions

• Work Set-up: Onsite
• Work Schedule: US hours, night shift; must be flexible to accommodate business needs.
• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.