Pharmacy Claims Specialist

Intelassist; Philippines; On-site; PHP 279,000 - 502,000; Full time

Benefits offered by this job

HMO coverage

Paid time off

Referral rewards

On-site training

Job summary

Intelassist in Eastwood, Quezon City, Philippines is seeking a Pharmacy Claims Specialist to oversee accounts receivable and minimize disputed and denied claims. You will ensure precise payments in line with payer contracts while coordinating with insurers and patients.

The role is full-time and onsite, operating night shifts aligned to the U.S. Eastern Time Zone, with HIPAA compliance and opportunities for career growth.

Qualifications

• Fluent English communication required.
• Experience in accounts receivable or denial management.
• Ability to coordinate with insurers and patients.
• Familiarity with payer contracts and HIPAA compliance.

Responsibilities

• Review balances and resolve invoices with insurers or patients.
• Handle appeals and denials to minimize disputed claims.
• Ensure accurate payments per payer contracts.
• Collaborate across intake and contracts teams for data accuracy.
• Participate in month-end closing procedures.

Tools

Microsoft Office Suite

EMR software

Payroll software

Job description

Employment Type

Full-Time Employment

Work Setup

100% Onsite

Work Schedule

Night Shift (Following U.S. Eastern Time Zone)

Location

Eastwood, Libis, Quezon City

About The Client

The client is a U.S.-based healthcare company that provides infusion therapy services for patients with chronic and complex medical conditions.

Job Description

The role of the Pharmacy Claims Specialist involves overseeing accounts receivable and minimizing the volume of accounts through the resolution of disputed and denied claims. Additionally, the Account Resolution Specialist will ensure precise payments in alignment with payer contracts.

Job Requirements

• Review account balances and resolve accounts/invoices by partnering with insurance companies and/or patients.


• Expert in handling appeals and denials.


• Excellent English communication skills.


• Collaborate with various departments to gather necessary information in order to have claims reprocessed or resubmitted.


• Coordinate with the intake team and contracts team to determine the accuracy of information loaded on patient accounts to avoid disputed or underpaid claims.


• Participate in end-of-month closing procedures


• Knowledgeable in NCPDP is a plus

Other Requirements

• Proficient in Microsoft Office Suite, EMR software, payroll software, and all other software programs.


• Must uphold all principles of confidentiality and patient care to the fullest extent while adhering to and complying with the Health Insurance Portability and Accountability Act (HIPAA) at all times.

What benefits await you by joining Intelassist?

• Global career advancement and networking opportunities.


• Access to both virtual and on-site intensive courses for career and personal development enhancement.


• Monetary rewards for successful referrals that are hired.


• Guaranteed weekends off and a total of 20 paid leave days upon regularization.


• Collaborative work environment


• Eligibility for Health Maintenance Organization (HMO) coverage starting from the first month of employment, with coverage of up to 100,000 PHP per illness.

WHY INTELASSIST?

We grow together. We value your effort. We aim to empower you.