Medical Claims Specialist

MicroSourcing; Philippines; On-site; PHP 279,000 - 469,000; Full time

Benefits offered by this job

Healthcare coverage

Dependent coverage

Paid time off with cash conversion

Group life insurance

Performance bonuses

Team events

Flexible work arrangements

Job summary

MicroSourcing in Eastwood, Quezon City, Philippines, is seeking a Medical Claims Specialist for onsite night shift. You will perform insurance verification, coordinate with clinical departments for scheduling, and support pre-visit readiness for patients.

The role requires 3+ years in medical office or insurance verification, strong payer knowledge, and EMR familiarity (eClinicalWorks). Onsite with competitive rewards and growth potential.

Qualifications

• Associate's degree preferred or equivalent work experience.
• 3+ years of experience in a medical office or insurance verification role.
• Strong understanding of commercial, government, and exchange-based insurance plans.
• Familiarity with EMR systems (eClinicalWorks preferred).
• Proficient in verifying coverage for high-cost services (imaging, injections, procedures).

Responsibilities

• Perform detailed insurance verification for outpatient and in-office procedures.
• Identify and flag non-covered services or potential coordination of benefits issues.
• Initiate and follow up on prior authorization requests, including appeals if necessary.
• Maintain organized tracking logs for authorizations and coverage status.
• Communicate coverage details to patients and collect out-of-pocket estimates if applicable.
• Serve as a subject matter resource to Patient Account Rep I staff.
• Work insurance queues to resolve pre-service issues that may delay care.
• Report payer trends or systematic verification issues to leadership.

Skills

Insurance verification

EMR systems (eClinicalWorks)

Attention to detail

Medical office experience

Communication with payers

Education

Associate's degree

Tools

eClinicalWorks

Job description

Discover your 100% YOU with MicroSourcing!

Position

Medical Claims Specialist

Work setup

Onsite | Night shift

Location

Eastwood, Quezon City

You’ll Have

• Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
• A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
• Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
• Career Growth: Take advantage of opportunities for continuous learning and career advancement.
• Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Key Responsibilities

The Medical Claims Specialist performs intermediate insurance verification and authorization duties with a growing level of responsibility. In addition to verifying insurance, this position coordinates with clinical departments to ensure accurate scheduling for covered services, resolves moderate issues with payers, and supports pre-visit readiness for patients.

• Perform detailed insurance verification for outpatient and in-office procedures.
• Identify and flag non-covered services or potential coordination of benefits issues.
• Initiate and follow up on prior authorization requests, including appeals if necessary.
• Maintain organized tracking logs for authorizations and coverage status.
• Communicate coverage details to patients and collect out-of-pocket estimates if applicable.
• Serve as a subject matter resource to Patient Account Rep I staff.
• Work insurance queues to resolve pre-service issues that may delay care.
• Report payer trends or systematic verification issues to leadership.

Qualifications

• Associate's degree preferred or equivalent work experience.
• 3+ years of experience in a medical office or insurance verification role.
• Strong understanding of commercial, government, and exchange-based insurance plans.
• Familiarity with EMR systems (eClinicalWorks preferred).
• Proficient in verifying coverage for high-cost services (imaging, injections, procedures).
• Excellent attention to detail and documentation skills.

Qualifications

• Associate's degree preferred or equivalent work experience.
• 3+ years of experience in a medical office or insurance verification role.
• Strong understanding of commercial, government, and exchange-based insurance plans.
• Familiarity with EMR systems (eClinicalWorks preferred).Proficient in verifying coverage for high-cost services (imaging, injections, procedures).
• Excellent attention to detail and documentation skills.

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan – it's our commitment. Our way of life. Here, we don't just accept your unique authentic self - we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit https://www.microsourcing.com/

• Terms & conditions apply