Claims Coordinator Specialist
Location
Taguig, Metro Manila
Job Type
Full-time
Category
other-general
Posted
June 19, 2026
Responsibilities:
- Assess payer medical policies and CMS guidelines to confirm medical necessity and coverage eligibility.
- Ensure clinical documentation aligns correctly with billing codes prior to service delivery.
- Coordinate and verify the completion of Advance Beneficiary Notices (ABNs) in the system, including correct use of modifiers.
- Apply Medicare guidelines and FDA labeling requirements when making coding determinations.
- Work closely with infusion intake, billing, and clinical teams to resolve coding inconsistencies.
- Identify and escalate complex reimbursement or compliance issues when necessary.
- Mainta...