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TASQ Staffing Solutions is currently hiring for highly skilled and detail-oriented professionals to join our team as a Medical Claims Processor. In this role, you will be responsible for accurately and efficiently processing and adjudicating healthcare claims. This position offers the opportunity to work with multiple clients, ensuring compliance with industry standards and relevant regulations.

Requirements:

College graduate from any field

3-6 months of experience in processing medical claims benefits for local or international accounts or related work

Work Details:

Virtual processing

Onsite position in Makati

Dayshift, gliding shift (8am-5pm)

Production-based incentives on top of salary and benefits (details to be provided by the client)

Responsibilities:

Review and analyze medical claims for accuracy, completeness, and eligibility.

Verify insurance coverage and policy information for each claim.

Calculate reimbursement amounts based on contract terms, fee schedules, and medical billing guidelines.

Utilize coding systems as necessary.

Ensure timely processing of claims within established turnaround times.

Investigate and resolve any discrepancies or issues, including coordination of benefits, authorization requirements, and prior approvals.

Communicate with healthcare providers, insurers, and clients to obtain additional information or clarification on claims.

Follow up on pending claims and outstanding documentation to ensure prompt resolution.

Maintain accurate records and documentation of all processed claims.

Adhere to regulations and maintain strict patient confidentiality.

Stay updated on industry changes, coding updates, and insurance policies to ensure accurate and compliant claim processing.

Collaborate with team members and provide support as needed to ensure efficient workflow and meet performance metrics.

If you meet the qualifications for this role, you can expect to receive communication for an interview within 24-72 business hours. Communication will be conducted via a phone call and a follow-up text and email.