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Medical Insurance Processor jobs

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    • Previous experience in U.S. insurance operations or commercial lines insurance.
    • Experience supporting an insurance agency, broker, or account management team.
    • View all The Entrepreneur LLC jobs - Work from Home jobs - Insurance Specialist jobs in Work from Home
    • Salary Search: Insurance Specialist (CL/PL) salaries in Work from Home
    • Strong understanding of the medical billing revenue cycle.
    • Communicate with insurance representatives regarding claim status and reimbursement.
    • At least six (6) months to 1 year relevant experience in medical insurance processes.
    • As an Insurance Specialist, you will support healthcare providers by…
    • Creating and submitting insurance claims.
    • Candidates should have hands-on experience working with medical billing workflows and be comfortable handling claims…
    • Working knowledge of DRG and APC concepts, readmission logic, medical necessity indicators, and post-payment review.
    • Member eligibility and cost share.
    • Proven experience in U.S. medical coding, medical billing, claims processing, or revenue cycle management (RCM).
    • Schedule: 8 HRS plus 1 HR non-paid break.
    • Follow up on outstanding insurance claims with Medicare and commercial insurance payers.
    • Comfortable communicating with insurance representatives.
    • 3+ years medical billing experience, with direct experience in pain management and/or ambulatory surgery center billing required.
    • Everyday responsibilities include processing data from medical coders, ensuring claims get processed and paid, verifying insurance coverage, reviewing denied…
    • Submit medical claims accurately and efficiently to insurance payers.
    • You will spend the majority of your day submitting medical claims, following up with…
    • In this role, you will be responsible for accurately and efficiently processing medical claims in compliance with payer requirements and internal policies.
    • Experience working with commercial insurance payers and payer portals.
    • Hands-on experience with healthcare insurance payer enrollment processes.
    • Support providers with patient labs, Durable Medical Equipment (DME) requests, medical administration, and referrals as needed.
    • The role of Claims Officer involves processing medical claims for clients in their assigned region.
    • Performance Incentive Plan / Yearly Bonus.
    • Bachelor’s degree in any medical allied course.
    • New Claims acknowledgment within 24hrs.
    • File and keep organized all claim files.
    • Must be keen on details.

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medical technologist
Insurance Specialist (CL/PL)
Work from Home
PHP 45,000 - PHP 55,000 a month
Full-time

Job details

Here’s how the job details align with your profile.

Pay

PHP 45,000 - PHP 55,000 a month

Job type

Full-time

Full job description

Job Overview

We are seeking an experienced Insurance Processing Specialist with strong Commercial Lines experience to support the day-to-day processing and servicing of insurance accounts. The ideal candidate is highly organized, detail-oriented, and comfortable managing multiple renewals, urgent requests, and complex accounts while meeting strict deadlines.

Experience with AMS360 and strong knowledge of insurance processing workflows are highly preferred.

Key Responsibilities

  • Create and process ACORD forms, which will be the primary responsibility of the role.
  • Request, track, and follow up on loss runs.
  • Process policy renewals and conduct timely follow-ups with carriers and relevant parties.
  • Handle RAIS follow-ups and submissions.
  • Complete insurance portal submissions accurately and within required timelines.
  • Process portal-based renewals and ensure all required information is submitted.
  • Prepare and complete supplemental applications as needed.
  • Prepare, organize, and attach supporting documentation required for submissions and renewals.
  • Monitor renewal dates and manage multiple accounts according to urgency, priority, and turnaround requirements.
  • Handle urgent and high-priority accounts with appropriate attention and follow-through.
  • Ensure all tasks are completed in compliance with established renewal timelines, carrier requirements, and internal processes.
  • Prioritize daily workload based on deadlines, urgency, and account requirements.
  • Manage and process complex, large, or time-sensitive accounts while maintaining accuracy and attention to detail.
  • Maintain complete and accurate documentation within AMS360 and applicable carrier portals.
  • Follow up proactively on outstanding items to prevent delays in the renewal and submission process.

Qualifications & Skills

  • Previous experience in U.S. insurance operations or commercial lines insurance.
  • Hands-on experience creating ACORD forms.
  • Experience processing renewals, loss runs, RAIS submissions, and supplemental applications.
  • Experience working with insurance carrier portals and portal-based renewals.
  • Working knowledge of AMS360.
  • Strong organizational and time-management skills.
  • Ability to manage multiple accounts and competing deadlines.
  • Strong attention to detail and accuracy.
  • Ability to identify and prioritize urgent and high-priority requests.
  • Strong written and verbal communication skills.
  • Ability to work independently and follow established processes.
  • Comfortable handling complex and high-value insurance accounts.

Preferred Experience

  • Commercial Lines insurance experience.
  • Experience supporting an insurance agency, broker, or account management team.
  • Experience working with multiple carrier portals.
  • Experience managing a high volume of renewals and time-sensitive submissions.

Ideal Candidate

The ideal candidate is a highly organized insurance professional who can work independently, prioritize effectively, and consistently meet strict renewal deadlines. They should be comfortable handling everything from routine ACORD creation and loss run requests to complex, urgent, and high-priority commercial accounts.

Pay: Php45,000.00 - Php55,000.00 per month

Work Location: Remote

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