Medical Csr jobs

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ActionLabs is composed of IT experts committed to providing end-to-end IT services and solutions. We stand at the intersection of technology and partnership, helping enterprises navigate complex IT landscapes with confidence.

With more than a decade of experience, trusted technology partners, nationwide presence, and a team of competent industry professionals, we aim to deliver managed services anytime, anywhere, to help businesses excel in their respective fields with improved internal and external operations.

Summary
The Customer Service Representative is responsible for supporting healthcare billing and reimbursement operations by managing insurance claims, resolving denials, and conducting accounts receivable follow-up activities. This role ensures timely claim resolution, accurate documentation, and effective coordination with insurance payers, healthcare providers, and internal teams to support efficient revenue cycle processes.

Key Responsibilities

• Review, analyze, and resolve denied, rejected, or unpaid insurance claims.
• Contact insurance companies to verify claim status, appeal denials, and address reimbursement issues.
• Prepare, correct, and resubmit claims through clearinghouse systems as necessary.
• Perform accounts receivable (AR) follow-up activities for outstanding claims and unpaid balances.
• Coordinate with hospitals, clinics, providers, and insurance payers regarding billing discrepancies and claim concerns.
• Monitor claim adjudication, payment activity, and reimbursement status.
• Maintain accurate documentation of claim actions, appeal progress, payer communications, and account updates.
• Identify root causes of denials and recommend corrective or preventive actions.
• Ensure compliance with payer guidelines, client requirements, HIPAA standards, and internal workflows.
• Maintain productivity and quality standards in accordance with client expectations.
• Escalate complex claims, payer disputes, or unresolved billing issues when necessary.

Qualifications

• Experience in medical billing, claims processing, denial management, AR follow-up, or healthcare revenue cycle management preferred.
• Knowledge of insurance claims, reimbursement processes, EOBs, and payer guidelines is an advantage.
• Familiarity with clearinghouses and medical billing systems preferred.
• Strong analytical, organizational, and problem-solving skills.
• Excellent written and verbal communication skills.
• High attention to detail and accuracy in documentation and claim handling.
• Ability to work in a fast-paced, metrics-driven environment.
• Relevant training, certification, or equivalent work experience may be considered in lieu of a degree.

Nice to have

• Experience supporting hospitals, clinics, or multi-site healthcare operations;
• Experience handling US-based payer communications;
• Background in healthcare BPO or offshore healthcare support is an advantage.

Work Setup

• Shift: US Business Hours / Night Shift
• Client: US Healthcare / Texas
• Internet Allowance provided

Pay: Php25,000.00 - Php40,000.00 per month

Benefits:

• Company Christmas gift
• Company events
• Health insurance
• Opportunities for promotion

Application Question(s):

• Are you willing to work on a night shift schedule?
• If currently employed, how long is your notice period?
• What is your expected monthly salary?

Work Location: Remote