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- ...The Risk Adjustment Coder is responsible for reviewing and accurately assigning diagnosis codes to medical records in accordance with ICD-10-CM coding guidelines, CMS-HCC Risk Adjustment methodologies, and client-specific requirements. This role ensures complete and compliant...Remote job
- ...opportunities as you help build its presence in the region. The Claims Coordinator i s responsible for setting up newly reported... ...as a key point of coordination between clients, insurance adjusters, and underwriters, ensuring timely claims handling, accurate documentation...
- ...be responsible for people and project management, carrying out administrative activity required to ensure effective management of claims administration team, payment allocation, claims reserves and total incurred review. The claims lead must know how the team processes...
- Responsibilities: ~- Review diagnosis and medication coding for infusion services, especially when payer limitations apply. - Assess payer medical policies and CMS guidelines to confirm medical necessity and coverage eligibility. ~- Ensure clinical documentation aligns...
- ...looking for experienced professionals to join us in Taguig as a Claims Assistant . In this role you will process insurance... ...submitted. Coordinate with Sales, Finance, insurers, independent adjusters, and repair shops to ensure timely premium remittance,...
720000 Php per year
...Job Title: PHRN/ USRN - Clinical Disability Claims Work Schedule: Shifting Work set up: Work from home Basic Pay: 60,700-85,700 + Allowances 5,675 No. of headcounts: 3 Target Start date: July 20th Qualifications: • Must have an active PHRN or USRN license...- This is a remote position. We are seeking an empathetic, detail-oriented, and fluent Bilingual Intake Specialist (Spanish/English) to join our growing team. In this role, you will be the first point of contact for prospective clients. You will be responsible for conducting...
775000 $ per day
...RESPONSIBILITIES: Provide analysis and reporting to maintain general ledger functions. Administer general claims and underwriting processing to ensure insurance quotes and proposals are reflected in tracking tools. Support customer service delivery and resolve inquiries...- ...Setup: On-site Locations: Muntinlupa Industry: Insurance Salary Range: Php 20,000 About the Job: Responsible for claims processing and compliance to the correct claims processing procedures and prompt settlement of claims. Required to operate on a...
- ...initiatives aimed at enhancing coding accuracy, maximizing reimbursement, and standardizing intake workflows. - Train and onboard new Claims Coordinators on systems, procedures, and industry best practices, while providing ongoing mentorship and operational support to...
- ...cash application transactions and customer account clearing activities in accordance with cash application procedure. AP Vendor Claims & Reconciliation Senior Associate Entry and mid Junior level in a Finance Administration role Strong team player with the ability...
- ...Job Description The Claims Analyst – Professional Billing (PB) is responsible for analyzing, auditing, and resolving claims related to professional (physician and ancillary) services to ensure accurate billing, coding, and reimbursement. This position plays a key role...
- ...Determine reimbursement eligibility Apply Medicare and payer guidelines Validate ICD-10, CPT, HCPCS coding Resolve reimbursement/claim issues Support compliance and audits Collaborate with billing, reimbursement, and clinical teams Recommend process...
- ...This is a remote position. Rockstar is hiring a full-time Medical Claims/AR Specialist - Virtual Assistant on behalf of a growing speech therapy practice. This role is focused on claims management — following up on outstanding claims, processing secondary billing...
- ...We are seeking a detail-oriented and experienced Insurance Denials Management Specialist to join our team, specializing in hospice claims. The ideal candidate will have a strong background in analyzing, appealing, and resolving insurance denials to optimize reimbursement...
- ...Key Responsibilities Review denied medical claims to determine reasons for denial (coding errors, missing information, medical necessity, eligibility, etc.). Collect, organize, and verify supporting documentation needed for appeals or audit Prepare and submit claim...
- Job Functions: • Input claim data into the system, ensuring all information is accurate, up-to-date, and properly filed. • Assist in collecting and organizing all necessary documentation for claims, including medical reports, receipts, and forms. • Review and assess...
Career Professionals, Inc.
Muntinlupa11 days ago - Job Functions: • Handle more complex or high-priority claims, ensuring all documentation is complete, accurate, and in compliance... ...regulations related to claims processing.. • Work closely with Claims Adjusters, Managers, and other departments (e.g., legal, underwriting) to...
Career Professionals, Inc.
Muntinlupa10 days ago - ...Key Responsibilities: Verify, analyze, and investigate whether claims are covered by the policy. Ensure that all claims for... ...turnaround time (TAT) set forth by the company. Collaborate with Adjusters and Processors to minimize and prevent fraudulent claims. Prepare...
WHR Global Consulting
Alabang, Muntinlupa, Metro Manilamore than 2 months ago - Work Arrangement: On-site | Dayshift | Monday-Friday Location: Muntinlupa City Employment Type: Full-time Job Summary: The Claims Processor is responsible for the efficient processing, management, and resolution of claims. Ensures accurate documentation, communication...
WHR Global Consulting
Muntinlupa18 days ago - Key Responsibilities • Supervise and mentor a team of claims officers and adjusters, ensuring an even distribution of workload and high standards of professionalism. • Review and monitor complex or high-value claims to ensure accuracy, timely processing, and adherence...
WHR Global Consulting
Muntinlupamore than 2 months ago - ...degree in a related field. Minimum of 7 years of experience in claims management. Strong understanding of claims processes and... ...process from start to finish. Manage and lead a team of claims adjusters. Review and approve high-value claims. Ensure all claims are...
Dempsey Inc
Pasig7 days ago - A Medical Claims Analyst-AR is responsible for the end-to-end recovery of medical payments. They act as a bridge between healthcare providers and insurance companies to ensure that claims are processed accurately and paid on time.
Stark Asia Solutions Inc
Pasigmore than 2 months ago - ...provides innovative solutions across various industries, particularly in cooling systems and compressors. Position: Mandarin Expense Claims Analyst Company Industry: Global Manufacturing Company Work Location: Quezon City Work Schedule: Dayshift Schedule (Monday to...
J-K Network Services
Quezon Citya month ago - ...Overview The AR Analyst / Senior AR Analyst is responsible for managing accounts receivable, ensuring timely follow-ups on outstanding claims, resolving denials, and maximizing collections from insurance payers. The role involves handling both routine and complex AR...
- ...inquiries, learning and development, recruiting, unemployment claims, and employment verifications within established SLA deadlines... ...apply, please tell us the pronouns you use and any reasonable adjustments you may need during the interview process. At Insight, we celebrate...
- ...Check • Act as a financial second-check on project billing — ensuring rate increases, price adjustments, and contract milestones have been correctly applied before claims go out. • Work from a contract summary document to identify what should have happened and verify...
- ...signatory. Please let us know if you require any reasonable adjustments/personalisation as part of the application process or to... ...for all. Please beware of fraudulent job postings and offers claiming to be from the Financial Times. All legitimate opportunities will...
- ...Review GMV Max campaign performance (cost, orders, CPA, ROI) and adjust target ROI as needed Audit GMV Max creative assets and... ...Manage chargebacks, fraud disputes, and escalated return or refund claims REQUIRED EXPERIENCE & SKILLS Platform & Technical...
- ...costing is supplied ~ Request necessary information ~ Submit claims for data issues ~ Identify areas of improvement and provide... ...this job include close vision, distance vision, and ability to adjust focus due to computer work. ~ Light to moderate lifting is...
