Medical Claims Billing Specialist (Philippines)

We’re hiring a full-time remote Medical Claims Billing Specialist to support Sailor Health’s growing Revenue Cycle Management operations. This is a highly execution-driven role focused on ensuring claims are submitted accurately, worked quickly, and reimbursed efficiently. You will spend the majority of your day submitting medical claims, following up with insurance payers, resolving denials, correcting claim issues, and ensuring timely payment across Medicare and commercial insurance plans. Your work will directly impact the financial health of the company and help ensure patients can continue accessing care without interruption. This role sits at the intersection of operations, billing, and payer management. It is ideal for someone who is detail-oriented, highly organized, persistent, and experienced in U.S. healthcare billing workflows.

Responsibilities

Submit medical claims accurately and efficiently to insurance payers; Review, track, and follow up on denied, rejected, unpaid, or stale claims; Work directly with insurance companies to resolve billing and reimbursement issues; Identify and resolve claim errors, eligibility issues, authorization gaps, and payer rejections; Submit corrected claims and manage appeals when necessary; Maintain accurate documentation and claim status updates across internal systems; Monitor aging claims and proactively escalate high-risk accounts or payer issues; Partner closely with intake, credentialing, clinical, and operations teams to resolve claim blockers quickly; Ensure timely and accurate workflows related to reimbursement and collections; Continuously improve billing workflows, operational efficiency, and claim turnaround times

Requirements

Experience in at least one of: medical claims billing; revenue cycle management (RCM); insurance claims follow-up and denials management; prior experience working in U.S. healthcare; Prior experience in U.S. healthcare billing or revenue cycle management is required; Strong understanding of claims submission, denials management, appeals, and payer follow-up workflows; Extremely detail-oriented and organized; Strong written and verbal English communication skills; Comfortable handling high-volume operational work with speed and accuracy; Ability to work independently in a fast-paced environment

Nice to have

Experience working with Medicare and commercial insurance payers strongly preferred; Experience using EHRs, billing systems, clearinghouses, or insurance portals preferred

Benefits

Mission with impact; Remote-first team; Growth and ownership; Make someone's day – every day