Job Status: Active
One of our client is looking to hire Senior Officer – Medical Direct Billing (Medical Insurance)
Key Responsibilities:
-Process and review direct billing claims for accuracy, medical necessity, and compliance
-Validate medical coding (ICD, CPT, HCPCS) and provider submissions
-Liaise with providers to resolve discrepancies
-Detect and escalate irregularities, fraud, or overutilization
-Support audits, analyze billing trends, and prepare reports
-Coordinate with Finance to ensure timely settlements within TAT
-Mentor junior staff and contribute to continuous improvement
Requirements:
-Bachelor’s degree in Allopathic Medicine, Health Science, Pharmacy, Physiotherapy, Nursing, Dentistry, or related field
-3–5 years of experience in medical claims processing (direct billing provider claims)
-Strong knowledge of medical treatments, billing, and terminology
-Skilled in claims review, coding validation, and fraud detection
-Excellent communication, negotiation, and leadership skills
-Fluency of the Filipino/Tagalog language is must for this role.
Interested contenders may apply by emailing their updated profiles to recruitment@metierme.net with the subject line mentioned as ‘Senior Officer – Medical Direct billing’.
Please note that only shortlisted candidates will be contacted for a further discussion.