Remote Healthcare Provider Claims Specialist

Imagenet; Makati; Remote; PHP 446,000 - 625,000; Full time

Benefits offered by this job

Competitive Pay + 13th Month Salary

Comprehensive HMO Coverage (Medical)

Equipment Provided – Everything you需要

Job summary

Imagenet is hiring a Healthcare Customer Service Advocate to remotely support healthcare providers with claims, appeals, and payment inquiries. You will handle emails, faxes, and web requests, ensuring timely resolutions while upholding HIPAA and company standards.

The role emphasizes strong communication, accuracy, and service levels, with a focus on nights, weekends, and holidays as part of shifting schedules. Immediate employment is emphasized.

Qualifications

• High school diploma or equivalent; college degree is an advantage.
• At least 4 years of experience in healthcare contact center, provider services, or claims support environment.
• Basic knowledge of healthcare claims, EOBs, appeals, and payment processes is an advantage.
• Excellent analytical, multitasking, organizational, and communication skills with strong attention to detail and accuracy.
• Tech-savvy, with proficiency in MS Office and online systems.
• Ability to work flexible shifts, including nights, weekends, and holidays.

Responsibilities

• Serve as the primary point of contact for healthcare providers and billing agencies regarding claims-related inquiries.
• Respond to inquiries about claim status, payments, appeals, and EOBs via phone, E-Mail, Fax, and web requests.
• Research and provide accurate information on claims, claim outcomes, and payment status.
• Investigate and resolve provider inquiries by coordinating with internal teams as needed.
• Provide updates on provider appeals and request additional documentation when required.
• Assist with payment-related requests, including stop payments, check reissuance, payment tracers, and copies of cashed checks.
• Process requests for upheld and late submission letters in accordance with company guidelines.
• Escalate complex or unresolved issues through the appropriate channels.
• Accurately document all customer interactions and maintain complete records in internal systems.
• Ensure compliance with HIPAA regulations, company policies, and confidentiality standards.
• Consistently meet service level agreements (SLAs), quality standards, productivity goals, and customer satisfaction expectations.
• Deliver professional, courteous, and solution-oriented customer service in every interaction.

Skills

Healthcare claims

Provider services

Customer service

Communication

HIPAA compliance

Education

High school diploma

College degree preferred

Tools

MS Office

Online systems

Job description

Imagenet is hiring a Healthcare Customer Service Advocate to remotely support healthcare providers with claims, appeals, and payment inquiries. You will handle emails, faxes, and web requests, ensuring timely resolutions while upholding HIPAA and company standards.

The role emphasizes strong communication, accuracy, and service levels, with a focus on nights, weekends, and holidays as part of shifting schedules. Immediate employment is emphasized.