Quezon City - Medical Records Coordinator (Insurance Verification)

Be a part of our fast-growing team and unchain all the possibilities!

What is your mission?

The ideal candidate is skilled in navigating electronic medical record systems (such as PrognoCis), understands U.S. insurance policies, and possesses in-depth knowledge of ICD-9/ICD-10, CPT/HCPCS coding, and medical terminology.

You will provide the best service to our partner brands by performing these tasks:

• Review structured clinical data against specified diagnoses, procedures, and medical terms
• Follow established protocols for authorizing or escalating medical service requests
• Respond to incoming calls from physicians, patients, and medical staff with excellent customer service
• Enter and attach patient information into the PrognoCis system accurately
• Schedule patient appointments as needed
• Contact patients for additional medical information when required
• Understand and process authorizations, benefits, and medical records for all patients
• Resolve denied prior authorization (PA) requests by coordinating with patients and clinical staff
• Maintain confidentiality and comply with U.S. HIPAA regulations
• Identify and resolve issues using sound judgment and problem-solving skills
• Independently manage workload and follow procedures with minimal supervision
• Maintain strong interpersonal communication in a diverse healthcare environment
• Track and respond to all inquiries from staff, patients, and payors within 24 hours
• Keep management updated on changes in authorization workflows and insurance policies
• Establish collaborative relationships with internal and external stakeholders
• Perform basic calculations and data entry with accuracy
• Operate computers and EMR systems for extended periods

• Has 2+ years of experience with insurance verification
• Has 3+ years of experience in medical records and referral coordination
• Is knowledgeable in Medicare, Medicaid, HMOs, PPOs, Workers’ Comp, and MVA claims
• Understands payor contracts, authorization workflows, and clinical coding
• Demonstrates excellent communication and customer service skills with staff and patients
• Is proficient in using EMR systems (e.g., PrognoCis) and follows HIPAA compliance
• Has strong problem-solving skills and the ability to work independently under tight deadlines
• Shows outstanding attention to detail and multi-tasking ability in a fast-paced setting
• Maintains professionalism, confidentiality, and responsiveness in all communications
• Has current medical knowledge and familiarity with U.S. healthcare processes

Company Perks:

• Above-industry salary package and incentives
• Comprehensive HMO benefits and life insurance from day 1
• Free learning and development courses for your personal and career growth
• Dynamic company events
• Opportunities for promotion
• Free meals and snacks