Skip to main content
Post your resume and find your next job on Indeed!

Medical Claims Processor jobs

Sort by: -
    • Submit claims to insurance providers.
    • Verify that all required claim forms, invoices, medical records, and supporting documents match and are complete.
    • View all PawPay jobs - Work from Home jobs - Quality Assurance Specialist jobs in Work from Home
    • Salary Search: Claims QA Specialist salaries in Work from Home
    • Experience working directly with a US-based dental office, OR with a company that provides billing and claims support for US BASED dental offices.
    • Reviewing electronic medical case files.
    • Reviewing insurance claims for next steps.
    • Compiling medical documents and entering case information.
    • Strong understanding of medical billing processes and insurance claims.
    • As a Medical Biller, you will support a US healthcare provider in managing the medical…
    • Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.
    • Prepare, review, and transmit claims using billing…
    • Submit medical claims accurately and efficiently to insurance payers.
    • You will spend the majority of your day submitting medical claims, following up with…
    • Creating and submitting insurance claims.
    • Managing denied and rejected claims.
    • Candidates should have hands-on experience working with medical billing workflows…
    • Strong understanding of medical billing workflows, claim submission, and coding fundamentals.
    • Maintain accurate billing records and claim documentation.
    • Review and process medical claims for submission to insurance companies or government programs.
    • Monthly medical allowance (after 6 months).
    • Review and process medical claims for submission to insurance companies or government programs.
    • Monthly medical allowance (after 6 months).
    • Investigate and resolve claim denials and underpayments.
    • Communicate with payers and provider offices regarding claim status.
    • Home Health : 1 year (Required).
    • 2+ years of experience working closely with US healthcare claims or in a claims processing/adjudication environment.
    • Work Setup: In‑Office Training Required.
    • Identify and correct medical billing errors.
    • Track and report claim trends to minimize denials.
    • Analyze and resolve claim discrepancies to prevent payment…
    • Enter and maintain accurate claim information in the claims management system.
    • Knowledge of insurance claims processes, healthcare claims, or relevant industry…
    • Correcting denial claims and resubmitting claims.
    • Everyday responsibilities include processing data from medical coders, ensuring claims get processed and paid,…

People also searched:

medical claims work from home
medical coder
medical scribe
medical technologist
medical virtual assistant
claims analyst
claims assistant
claims processor
claims specialist
insurance

Job Post Details

Claims QA Specialist - job post

PawPay
Remote
PHP 50,000 - PHP 65,000 a month

Job details

Pay

  • PHP 50,000 - PHP 65,000 a month

Job type

  • Full-time

Full job description

Apply here: https://forms.clickup.com/9016879278/f/8cq5a5e-13536/PBJJL8FCKB01LJQD4F

Location: Remote

Status: Full-time

Position Summary

PawPay is seeking a detail-oriented team member to drive operational excellence across our claims ecosystem. This hybrid role bridges active claims processing and external stakeholder coordination with high-level quality auditing.

This is an excellent opportunity for individuals looking to build experience in healthcare administration, insurance operations, customer support, or claims processing.

We are looking for someone who:

  • Enjoys working with processes and documentation.
  • Is highly organized and detail-oriented.
  • Takes ownership of tasks and follows through consistently.
  • Communicates professionally and proactively.
  • Can work independently while collaborating with a growing team.
  • Is excited to help improve the experience for pet owners and veterinary clinics.

Key Responsibilities

Claims Management

  • Review claim documentation submitted by pet owners and veterinary clinics.
  • Verify that all required claim forms, invoices, medical records, and supporting documents match and are complete.
  • Submit claims to insurance providers.
  • Maintain accurate tracking of claim statuses.
  • Maintain organized digital records within company systems.
  • Monitor claims, manage workflow queues, and ensure full compliance with SOPs and insurance regulations.

Stakeholder Communication

  • Act as a primary liaison with insurance carriers.
  • Execute and audit follow-ups across phone calls, email, and SMS messaging.
  • Ensure all phone interactions are professional, and written emails and SMS outreach are clear and compliant to TCPA guidelines.

Quality Assurance, Financial Reconciliation and Appeals

  • Conduct audits on open and closed claims to review carrier decisions,
  • Evaluate disputed or denied claims to determine eligibility for appeals.
  • Execute financial reconciliation on paid invoices against approved reimbursements.
  • Verify the correct direction of reimbursement.
  • Identify discrepancies, systemic documentation issues, or trend errors.

Qualifications

Work Experience

  • 1+ years of insurance industry experience (e.g. claims, policy administration) or 2+ years of general experience in customer service, client communications or quality auditing.
  • Strong understanding of workflows and compliance requirements
  • Excellent English communication (both written and verbal)
  • Comfortable with spreadsheets, CRM tools, and AI-powered platforms.

Competency Requirements

  • Strong attention to detail with the ability to identify process gaps, missed opportunities, and compliance risks
  • Proactive problem-solving mindset with the ability to recommend practical solutions
  • Time management and organization skills to manage claims volumes and deadlines
  • Adaptability to changing processes, policies, and business requirements
  • Able to work independently with minimal supervision.

Device Specifications

  • Noise-canceling headphones
  • Built-in or external camera
  • Internet Speed: Minimum of 50mbps

Pay: Php50,000.00 - Php65,000.00 per month

Work Location: Remote

Let Employers Find YouUpload Your Resume