Medical Records Clerk/Claims Processor and Medical Biller
Philippines
As a dedicated Medical Records Clerk with hands‑on experience in medical billing and claims processing, you bring strong administrative precision and a deep understanding of healthcare documentation requirements. You are skilled in maintaining accurate patient records, ensuring compliance with HIPAA standards, and supporting smooth clinical and financial workflows. Your background in billing and claims allows you to coordinate effectively with providers, insurance companies, and patients to resolve discrepancies, verify coverage, and facilitate timely reimbursements. With strong attention to detail, excellent organizational abilities, and a commitment to data accuracy, you contribute to efficient healthcare operations and high‑quality patient support.
Community General Hospital of San Pablo City Inc., full_time
May 2017 to Mar 2026
Medical Records Clerk / Claims Processor Department Awarded: Lowest Return & Denied Claims – Top 3 Regional Ranking (3 Consecutive Years) Processed and reviewed medical insurance claims to ensure accuracy, completeness, and compliance with PhilHealth guidelines and hospital policies. Verified patient records, diagnoses, procedures, and supporting documents prior to claims submission to minimize errors and prevent denials. Coordinated with physicians, nurses, and billing staff to clarify discrepancies and obtain required documentation. Submitted claims within prescribed timelines and monitored claim status to ensure timely reimbursement. Analyzed returned and denied claims, corrected deficiencies, and facilitated prompt resubmission. Maintained organized and confidential patient medical records in compliance with data privacy regulations. Contributed to departmental quality control initiatives that resulted in the lowest return claims and lowest denial rate as recognized by the PhilHealth office. Played a key role in achieving Top 3 Regional Ranking for three consecutive years for claims accuracy and processing efficiency. Assisted in training new staff on claims processing procedures and documentation standards.