Remote EDI Claims Consultant - Healthcare

Vector Outsourcing Solutions Philippines; Mandaluyong; Hybride; PHP 279 000 - 391 000; Plein temps

Avantages offerts par ce poste

Maternity & Paternity Leave

Government Contribution (SSS, Pag-IBIG

13th Month Pay

Paid Holidays

Bereavement Leave

Paid Vacation Leave

Paid Sick Leave

Work from Home

Résumé du poste

Vector Outsourcing Solutions Philippines is seeking a detail-focused Healthcare EDI Specialist to join our billing operations in Mandaluyong. You will handle submitting claims, monitoring electronic documents, and coordinating with clearinghouses to resolve issues, while ensuring data integrity and timely repairs.

The role requires 2+ years in Healthcare EDI or Medical Billing, proficiency with EHR/EMR systems, and strong analytical and communication skills in a fast-paced environment.

Qualifications

• At least 2 years of experience in Healthcare EDI, Medical Billing, or Claims Processing.
• Knowledge of EDI processes, claim submissions, clearinghouses, and rejection management.
• Familiar with healthcare insurance payers, claim edits, and reimbursement processes.
• Experience using EHR/EMR systems and billing software is preferred.
• Strong analytical, problem-solving, and organizational skills.
• Excellent communication and coordination skills.
• Detail-oriented and able to work in a fast-paced environment.
• Open to consultancy contract minimum of 6 months.

Responsabilités

• Submitting medical claims to the proper clearinghouse for review and payments.
• Processing & monitoring of all claim reports & electronic documents.
• Logging in and tracking all submission and rejection information.
• Repairing claims for re-submission and ensuring proper clearinghouse submission.
• Backup the EDI claim submission and logging of information.
• Coordinating & testing all EDI implementations with new Partners & clearinghouse.
• Coordinate and work with clearing houses or trading partners to resolve EDI issues.
• Test, implement and document all processes required by new accounts or new billing software.
• Monitors daily EDI performance and troubleshoots issues.

Connaissances

EDI knowledge

EDI processes

Analytical skills

Communication skills

Detail-oriented

Fast-paced environment

Outils

EHR/EMR systems

Billing software

EDI tooling

Description du poste

Vector Outsourcing Solutions Philippines is seeking a detail-focused Healthcare EDI Specialist to join our billing operations in Mandaluyong. You will handle submitting claims, monitoring electronic documents, and coordinating with clearinghouses to resolve issues, while ensuring data integrity and timely repairs.

The role requires 2+ years in Healthcare EDI or Medical Billing, proficiency with EHR/EMR systems, and strong analytical and communication skills in a fast-paced environment.