Medical Claims Analyst

Our brand, Lennor Metier Consulting, a DOLE-licensed headhunting and recruitment agency in the Philippines, is proud to partner with a global RCM Company in their search for a Medical Claims Analyst based in Ortigas.

Industry: Healthcare

Salary Range: ₱33,000 Package

Work Setup: Onsite

Work Schedule: Night Shift

Location: Ortigas

Job Overview

We are looking for a Medical Claims Analyst to manage claim processing, billing, collections, and account reconciliation. This role involves ensuring timely resolution of outstanding claims, identifying billing discrepancies, and maintaining compliance with healthcare regulations. You will work closely with payers, clients, and internal teams to drive efficiency and accuracy in claim management.

Your Responsibilities

Claims Processing & Resolution

• Follow up on outstanding claims via phone, email, or online portals.
• Analyze and resolve claim discrepancies to prevent payment delays.
• Identify and correct medical billing errors.
• Process appeals with proper documentation and communication.
  
  

• Maintain accurate records of underpayments, overpayments, and credit balances.
• Conduct research on payer-specific billing guidelines and policies.
• Adhere to timely filing deadlines and compliance standards.
  
  

• Track and report claim trends to minimize denials.
• Ensure compliance with HIPAA and data protection regulations.
• Maintain confidentiality and professionalism in all interactions.
  
  

• Work independently while coordinating with internal teams on claim resolutions.
• Provide support on special Accounts Receivable (A/R) projects as needed.
• Act courteously and professionally with patients, providers, and stakeholders.
  
  

• Education: At least a high school graduate.
• Experience: Minimum 1 year of US Insurance Follow-Up (outbound) experience.
• Strong understanding of claims processing for providers (physicians and/or hospitals).
• Ability to explain EOBs, claims, and denials effectively.
• Communication: Above-average English communication skills.
• Work Setup: Must be willing to work onsite in Ortigas, Pasig.
• Schedule: US shift (9 PM – 5 AM) with fixed weekends off.
  
  

• We kindly request your patience as we receive a significant number of applications. Rest assured that our team will update your applications status soon. In the meantime, we encourage you to follow our LinkedIn page to stay informed about future opportunities and company updates.