Night-Shift Medical Claims & Denials Specialist – Cebu

Sound Connection Phils. Inc.; Cebu City; On-site; PHP 391,000 - 446,000; Full time

Benefits offered by this job

HMO and health insurance

Night differential and holiday premium

Service incentive leave

Weekends off

Direct hire

Job summary

Staff Outsourcing Solutions in Cebu City seeks an Insurance Claims Specialist for Medical Claims and Denials to work night shift onsite. The role handles medical insurance claims, denials, and appeals for US-based accounts receivable teams.

Six openings exist, with a salary package of PHP 35,000 to 40,000 per month plus a performance bonus up to $750 monthly. The ideal candidate has at least 1 year of medical claims experience, strong denial processing skills, and precise English for payer

Qualifications

• At least 1 year of solid experience in medical claims (provider side).
• Hands-on knowledge of denial processing is required.
• Ability to communicate in written and verbal English for payer calls and claim notes; accuracy matters.

Responsibilities

• Review, process and manage medical insurance claims.
• Handle denial processing and resolve claim issues promptly.
• Ensure compliance with insurance standards and policies.
• Work with internal teams to clarify and elevate claim discrepancies.
• Track outstanding claims with insurance companies.
• Contact payers to inquire about claim status, address delays, and resolve issues.
• Follow up with insurance carriers to determine denial reasons and work the claim to payment.
• Analyze unpaid medical claims and denials to determine actions needed to resolve them on time.
• Investigate denial reasons, identify errors, and take corrective action, including submitting appeals.

Skills

Medical claims

Denial processing

English communication

Job description

Staff Outsourcing Solutions in Cebu City seeks an Insurance Claims Specialist for Medical Claims and Denials to work night shift onsite. The role handles medical insurance claims, denials, and appeals for US-based accounts receivable teams.

Six openings exist, with a salary package of PHP 35,000 to 40,000 per month plus a performance bonus up to $750 monthly. The ideal candidate has at least 1 year of medical claims experience, strong denial processing skills, and precise English for payer