Medical Claims Associate

Connext Global Solutions is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.

We are currently looking for an Medical Billing Specialist (Claims) to support our client based in the US.

What's in it for you?

There's a lot to love about Connext. Here are some of the reasons why:

• Competitive salary and bonuses
• 25% Night Differential Pay
• 20 Annual Leave Credits
• Health, dental, and life insurance
• Fun HR virtual and onsite events
• Professional development and training opportunities
• Employee assistance programs (EAP)
• Employee volunteer and community service opportunities
• Amenities for leisure and recreation
• Certified Great Place to Work (2022)

What is the job?

The Medical Claims Specialist is responsible for managing hospital and/or physician billing collections, ensuring accurate and timely processing of claims, and facilitating prompt payment from payers. This role will also work closely with various insurance providers, including Medicare, Medicaid, Blue Cross, and commercial health insurance carriers, to ensure accurate and timely reimbursement for medical services rendered.

• Examine medical claims to ensure accuracy and completeness.
• Verify health insurance benefits and coverage for patients.
• Follow up with payers regarding claim status and outstanding balances.
• Identify and resolve issues preventing timely claim resolution.
• Correct and resubmit claims as necessary to ensure prompt payment.
• Maintain detailed documentation of all billing and collections activities.
• Provide expert customer service to patients and insurance providers.
• Ensure compliance with legal and regulatory requirements at all times.

What you bring to the job?

• At least 1 to 5 years of experience in Revenue Cycle Management
• At least 1 year of experience with Claims processing
• Familiarity with Medicare, Medicaid, and Blue Cross claim submission processes and requirements is a plus.
• Excellent written and verbal communication skills in English
• Have high energy, be a self-starter, great teammate and ready to roll up your sleeves to get things done
• Comfortable in working with US-based client
• Good tenure with previous companies (stays with companies for at least a year)
• Willing to work onsite in 2nd Floor, Hai Global Building, Pryce Business Park, J.P. Laurel Avenue, Poblacion District, Davao City
• Willing to work from 9:00 PM - 6:00 AM; Monday to Friday (Philippine Time)