Remote Medical Claims Examiner – ASAP Start

Imagenet, LLC; Manila; Hybrid; PHP 391,000 - 614,000; Full time

Benefits offered by this job

Comprehensive HMO coverage

HMO coverage Day 1 + dependent

Transportation allowance

Equipment provided

Job summary

Imagenet LLC is seeking Medical Claims Examiners to join our Manila team. You will process and adjudicate medical claims, verify eligibility and credentialing, and collaborate with internal teams to resolve discrepancies. Training is provided with a pathway to remote work after onboarding.

Prior US claims experience is required, and the role offers benefits and ongoing development opportunities. Initially, in-office training is required in Makati, with the potential to move to remote work upon

Qualifications

• 2+ years of experience in US healthcare claims or claims processing.
• Understanding of health claims processing/adjudication.
• Medical terminology knowledge preferred.
• Understanding of ICD-9 and ICD-10.
• Ability to perform basic to intermediate mathematical computation routines.
• Basic MS Office skills.
• Ability to work independently or within a team.
• Time management and attention to detail.
• Written and verbal communication and sound decision-making abilities.

Responsibilities

• Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies
• Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
• Communicate with internal resources and stakeholders to resolve claim discrepancies or request additional information.
• Review, evaluate and process Encounter data, Professional and Institutional Claims for all lines of business.
• Ensure claims payment and denial accuracy and compliance with turnaround times.
• Participate in ongoing training and professional development.
• Maintain accurate and detailed records of claims processing activities.
• Identify and escalate complex or unusual claims for further review or investigation.
• Handle more complex claims with multiple services and providers

Skills

US healthcare claims experience

Healthcare claims processing

Medical terminology

ICD-9/ICD-10

Basic MS Office

Time management

Written and verbal communication

Attention to detail

Decision making

Independent or team work

Job description

Imagenet LLC is seeking Medical Claims Examiners to join our Manila team. You will process and adjudicate medical claims, verify eligibility and credentialing, and collaborate with internal teams to resolve discrepancies. Training is provided with a pathway to remote work after onboarding.

Prior US claims experience is required, and the role offers benefits and ongoing development opportunities. Initially, in-office training is required in Makati, with the potential to move to remote work upon