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🥝 Medical Claims Analyst

Risewave Consulting Inc. | pasig, Philippines | Posted June 04, 2026

Job Description

The Medical Claims Analyst is responsible for collections, account follow-up, billing, and allowance posting for assigned accounts. The role ensures accurate, timely resolution of outstanding claims through proactive follow-up and analytical problem-solving.

Responsibilities

  • Follow up with payers via phone, email, fax, or payer portals to ensure timely resolution of outstanding claims.
  • Meet and maintain daily productivity and quality standards.
  • Use workflow systems, client host systems, and other tools to collect payments and resolve accounts.
  • Adhere to all client and team policies and procedures.
  • Maintain knowledge of timely filing deadlines for designated payers.
  • Research payer-specific billing guidelines as needed.
  • Analyze and resolve issues causing payer payment delays.
  • Identify trends in claim issues to proactively reduce denials.
  • Communicate identified issues and trends t...

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