3 Clinical Management jobs in the Philippines

Junior Medical AR & Denial Management Specialist

Muntinlupa, National Capital Region Gear Inc

Posted 21 days ago

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Job Location:  Muntinlupa, Metro Manila, Philippines

Job Name:  Junior Medical AR & Denial Management Specialist

Job Description

Sign-On Bonus Offered!

Join us and receive a competitive sign-on bonus as a welcome to our growing team!

Our leading AI platform specializing in medical billing operations, is seeking dedicated and detail-oriented Medical AR and Denial Management Specialists to join our team. The ideal candidates will have at least 6 months of experience in medical billing, AR calling, Denial Management or a related field and possess strong English proficiency. As part of our client-facing team, you will be providing vital support to client operations by ensuring accurate and compliant medical billing operations through outbound calling, data categorization, and transcript analysis.

Key Responsibilities:

1. Outbound Calling:

  • Make outbound calls to insurance companies and payors to collect essential information, including claim statuses, denial reasons, and any additional relevant details.
  • Conduct all calls in full compliance with the Client's guidelines and applicable healthcare regulations.
  • Maintain professionalism and ensure clear communication during each call.

2. Data Categorization and Labeling:

  • Accurately record, categorize, and label calls or information gathered using the taxonomy and definitions provided by the client.
  • Ensure all claim statuses and call outcomes are properly labeled for consistency in reporting and easy analysis.
  • Deliver categorized data in periodic reports or through the portal developed by client, following the requested format and frequency.

3. Call Transcript Analysis:

  • Analyze recorded call transcripts to extract actionable insights, identifying trends, recurring denial reasons, and other patterns.
  • Compile findings into periodic reports, providing valuable information to the Client to support process improvements and optimize workflows.


Qualifications:

  • Minimum of 6 months of experience in medical billing, insurance claims, or a related field.
  • Strong English proficiency, both verbal and written.
  • Familiarity with healthcare regulations and industry guidelines.
  • Excellent communication skills with the ability to make outbound calls to insurance companies and payors.
  • Detail-oriented and able to maintain accurate records.
  • Ability to work independently while adhering to internal guidelines and procedures.
  • Proficiency in Microsoft Office Suite or similar software; experience with medical billing software is a plus.

Additional Information:

This is a full-time position, and the successful candidate will work closely with the clients team to support their AI-powered platform in improving medical billing operations. The role offers an opportunity for professional growth and development within a dynamic, technology-driven environment.

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Healthcare Project Management- Project Manager for Installation

Taguig, National Capital Region GE HealthCare

Posted 10 days ago

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**Job Description Summary**
Healthcare Project Management (HPM), responsible for managing wing to wing projects of GE Healthcare (GEHC) business, owns the project management and implementation process for GEHC Diagnostic Imaging, including sales order review, customer meeting, project planning, design/layout, contractor interface, submission of documentation, issue resolution, GE resources coordination which includes product shipping logistics, installation and training.
As related customer equipment, facilities or infrastructure projects:
- responsible for project delivery, profit & loss accountability, and customer satisfaction through management of project related activities and resources.
- Impacts quality of own work and the work of others on the team.
- Executes standard operational/technical tasks typically subject to instructions and work routines.
There is latitude to rearrange the sequence to complete task/duties based on changing work situations.
GE HealthCare is a leading global medical technology and digital solutions innovator. Our purpose is to create a world where healthcare has no limits. Unlock your ambition, turn ideas into world-changing realities, and join an organization where every voice makes a difference, and every difference builds a healthier world.
**Job Description**
**Essential Responsibilities:**
**Customer facing**
+ Lead complicated projects and drive strategic account execution by adapting a proactive approach to identify risks to project success and create and maintain a project risk log; develop effective action plans for resolution as early as possible.
+ Provide leadership to customer issue resolution in the technical capacity to improve contribution margin, site quality, vendor selection and safety
+ Drive customer satisfaction and process productivity during the installation process ensuring that installations & trainings are completed in a timely and quality manner in accordance with defined global standards, milestones and customer satisfaction matrix
**Internal**
+ Provide guidance and drive closure of project issue resolution to internal stakeholders through timely escalation o fissues.
+ Act as key technical liaison to country cross functional teams - Sales, Modality, Services, OTR, Design Center, to drive continuous process excellence, including quality and safety for the respective projects assigned .
**Regional**
+ Drive/Participate in weekly coordination meeting and drive process improvement in technical arena regionally and globally
+ Review regional & country technical process to drive down GE costs - OCCR, installation costs, construction costs, etc.
+ Additional and ad hoc projects and tasks assigned by manager.
**Qualifications/Requirements:**
+ Bachelor's degree or equivalent technical field experience, majoring in BioMedical Engineering, Electrical Engineering, Mechanical Engineering, Mechatronic Engineering, Automation Engineering, Civil Engineering or related field.
+ 5 years experience in cross-functional for project integration, sale and service support.
+ Strong project management skills are required.
+ Knowledge in construction field (civil, structural, architectural, electrical and HVAC) with local regulation and global standard codes is preferred.
+ Ability to work independently and prioritize multiple priorities to meet scheduled completion dates, execute multiple commitments within the constraints of environment and customer expectations.
+ Resourcefulness, commitment, interpersonal, communication and negotiation skills.
+ Must have a valid driver's license.
+ Must be willing and able to travel regularly, flexible schedule and including overnight when necessary.
+ Working knowledge of Microsoft Windows and Office Applications
+ Knowledge of AutoCad or other Designing tool
+ Fluent (oral and written) in English
**Desired Characteristics**
+ Background in healthcare medical equipment project management and installation.
+ Construction field experience for hospital construction such as civil work, structural, HVAC and clean room is desirable.
+ Multitasking abilities to drive critical issues simultaneously.
+ Independently lead a customer through all aspects of design and requirements.
+ Experience in managing people and tasks.
+ Experience working with cross functional teams
+ Professional Certification is a plus
+ Experience working for a Multinational company is a plus
**Inclusion and Diversity**
GE HealthCare is an Equal Opportunity Employer where inclusion matters. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law.
We expect all employees to live and breathe our behaviors: to act with humility and build trust; lead with transparency; deliver with focus, and drive ownership - always with unyielding integrity.
Our total rewards are designed to unlock your ambition by giving you the boost and flexibility you need to turn your ideas into world-changing realities. Our salary and benefits are everything you'd expect from an organization with global strength and scale, and you'll be surrounded by career opportunities in a culture that fosters care, collaboration and support.
# LI - SE
#LI-ONSITE
#LI-HYBRID
**Additional Information**
**Relocation Assistance Provided:** No
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Sr. Patient Financial Services - Revenue Cycle Management, Healthcare Finance

Manila, Metropolitan Manila Amazon

Posted 13 days ago

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Description
Working Conditions:
-Fixed night shift schedule (start time of 9PM but can change depending on business need).
-Report daily to the Pasay office.
-Knowledge of reading an Explanation of Benefits (EOB), denial management and denial codes is required
-Familiarity with Medicare and Medicare Advantage programs
-Minimum 1 year of working experience in Revenue Management Cycle (RCM) preferably in US healthcare
The Finance Operations organization works with every part of Amazon to provide operations accounting and operations excellence services with the highest level of controllership at the lowest cost to the company. We provide the backbone systems and operational processes which completely, accurately, and validly pay Amazon's suppliers, invoice our customers and report financial results. Amazon is quickly building the Finance Operations capabilities in the healthcare industry by creating the Healthcare Finance Operations Services.
As part of the Amazon Healthcare Global Finance Operations Services team, you will find yourself working with exceptionally talented and determined people committed to driving financial improvement, scalability, and process excellence. To support the growth of Amazon HealthCare, this candidate must possess a strong passion for accountability, setting high standards, raising the bar, and driving results through constant focus on improving existing and future state operations, systems, and processes in collaboration with Management.
As we continue to grow and scale our ability to provide innovative primary care across the country, the teams that support this critical work are growing as well. Amazon Healthcare is seeking to hire Patient Financial Services professionals (RCM) for the Revenue Cycle team. As a member of the Revenue Cycle team, you will be working in the Revenue Cycle Team ensuring that our members get the best billing experience available. You will help us to attain this goal by assisting administrators with member inquiries and doing pro-active reach outs to members with large balances.
Key job responsibilities
- Handle tasks via our offline chat using One Medical tools
- Oversee comprehensive revenue cycle management operations while ensuring compliance with healthcare billing regulations.
- Assisting admins with our member's billing needs via 1Life's tasking system to provide the best customer service
- Answering patient inquiries for complex billing cases and questions
- Investigating claims through insurance to ensure they were processed according to the patient benefit plan via internal tools
- Supporting One Medical through processes aimed at empowering our patients to resolve any financial responsibilities
- Reviewing and reconciling patient and insurance balances for accuracy
- Managing the member statement process, by ensuring bills are efficiently and accurately sent
- Maintaining service level agreements in response time to admins and patients
Basic Qualifications
- Minimum a Bachelor's degree in any field
- Prior experience of at least 1 year in Accounts Receivable in RCM or in US healthcare revenue cycle operations.
- Knowledge of reading an Explanation of Benefits (EOB), denial management and denial codes is required
- Familiarity with Medicare and Medicare Advantage programs
- Understanding of Coordination of Benefits and Eligibility
- Customer service exposure to anything related to revenue cycle-billing insurance
- Experience working in shared services environment with productivity targets
- Experience in US healthcare and insurance landscape
- Understanding of basic accounting principles and receivables management
- Proven ability to adhere to policies and procedures, as defined by leadership
Preferred Qualifications
- 2+ yrs experience with US healthcare and health insurance industry
- Prior AR Collections or back office experience
- CRCR cert preferred
- Has led or been part of a team that worked on a Six Sigma belt project / Kaizen / Lean projects
Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit for more information. If the country/region you're applying in isn't listed, please contact your Recruiting Partner.
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