Medical Claims Analyst jobs

Key Responsibilities

Medical Billing & Claims Management

• Prepare, review, and submit a high volume of insurance claims daily.
• Manage the full billing workflow from claim creation through payment posting and account follow-up.
• Submit claims accurately to clearinghouses and ensure timely processing.
• Monitor claim status and proactively resolve billing issues.

Denials & Revenue Cycle Management

• Investigate, appeal, and resolve claim rejections and denials from start to finish.
• Identify billing errors, make necessary corrections, and promptly resubmit claims.
• Maintain a strong understanding of Coordination of Benefits (COB) to ensure accurate claim processing.
• Apply CPT and HCPCS modifiers correctly based on payer requirements and clinical documentation.
• Ensure compliance with insurance payer guidelines across multiple commercial and government payers.

Communication & Patient Support

• Communicate professionally with healthcare providers regarding documentation and billing questions.
• Assist patients or parents/guardians with billing inquiries and account balances.
• Collect payments over the phone and establish payment arrangements while providing excellent customer service.

Required Qualifications

• Extensive hands-on experience in medical billing with a proven track record of managing high claim volumes.
• Strong experience submitting claims to insurance clearinghouses.
• Demonstrated success resolving claim rejections and denials through to payment.
• Thorough understanding of Coordination of Benefits (COB).
• Strong knowledge of CPT/HCPCS coding modifiers and their appropriate application.
• Solid understanding of insurance payer guidelines and billing requirements across multiple payers.
• Ability to identify billing issues, correct claims, and resubmit them with minimal supervision.
• Experience managing the complete medical billing lifecycle from claim submission through payment posting and collections.
• Strong analytical, organizational, and problem-solving skills.
• Ability to work independently while managing multiple priorities in a fast-paced environment.

Preferred Qualifications

• Experience using AdvancedMD (strongly preferred).
• Experience communicating directly with providers regarding documentation and billing issues.
• Experience assisting patients or parents/guardians with billing questions.
• Comfortable collecting payments by phone and establishing payment plans.
• Experience working with multiple insurance carriers and specialty practices.

What We're Looking For

The ideal candidate has been deeply involved in every aspect of the medical billing process—not someone whose recent experience has been limited to supervising a billing team. You should have a comprehensive understanding of the entire revenue cycle, be able to troubleshoot billing challenges independently, and consistently keep claims moving efficiently from submission through reimbursement.

If you're detail-oriented, proactive, and thrive in a fast-paced billing environment, we'd love to hear from you.

Pay: Php80,000.00 - Php120,000.00 per month

Benefits:

• Work from home

Application Question(s):

• Do you have an experience with AdvancedMD

Experience:

• Medical billing: 5 years (Required)
• CPT/HCPCS coding: 3 years (Required)

Work Location: Remote