EDI Consultant (Healthcare) | Work From Home
At Vector Outsourcing Solutions Phils. Inc. · Mandaluyong City, Metro Manila, Philippines
Salary: ₱25,000 – ₱35,000 a month
- Full-time
Early applicant Posted 15 hours ago. Radar members get jobs like this within hours.
See how well you match Match me reads your CV and picks the jobs that suit you best.
Get jobs like this within hours On Gumroad, with a card.
Where you can work from
Open to the Philippines
“Mandaluyong City, Metro Manila, Philippines”
From the location.
Report a mistake
- Posted
- 15 hours ago
- First seen by us
- 21 October 2026
- Last checked
- 15 hours ago
Job description
From Vector Outsourcing Solutions Phils. Inc.’s job post, as they wrote it.
Salary: PHP 25,000 - PHP 35,000/ month
Job Description:
* Submitting medical claims to the proper clearinghouse for the insurance payers to review and make the proper decision and payments.
* Processing & monitoring of all claim reports & electronic documents. (Electronic and Paper Claim Transactions).
* Logging in and tracking all submission and rejection information.
* Responsible for obtaining edit reports and repair claims for re submission, test, and ensure repairs are made in a timely manner. Make sure that the claim was sent to the proper clearinghouse.
Read the full description
* Backup the EDI claim submission and logging of information.
* Keeps an update of Policy, Regulations and Payer/Clearinghouse changes.
* Coordinating & testing all Electronic Data Interchange (EDI) implementations with new EDI partners & current clearinghouse.
* Coordinate and work with clearing houses or trading partners to resolve EDI issues such as rejection and submission errors. Collaborate with payers, clearinghouses and/or trading partners to successfully maintain the EDI processes.
* Test, implement and document all processes required by the new accounts or new billing software.
* Reviews, analyzes and coordinates implementation for service modifications by EDI ( new payer ID, claim edits)
* Monitors daily EDI performance, analyzes complex datasets, and troubleshoots issues and resolve them in a timely manner.
* Facilitates the successful on-boarding of new Clients EDI accounts.
* Assure interfaces (ECPP, QRSP, and HPNA) are performing as designed.
* Assure data integrity (correct files/batches are uploaded)
* Manage the resolution process as needed (Coordination with Team, Leaders, account Manager)
* Escalate EDI issues to Manager/ Credentialing if unable to resolve in a timely manner.
* Manage Send/Receive Files, Work Rejected claim (daily).
* Random Claim Status inquiry.
* Claim File Reconciliation (batch received by charges and batch submitted by EDI)
* Analyze Rejection and detection of error patterns that need correction on the billing end.
Minimum Qualifications:
* At least 2 years of experience in Healthcare EDI, Medical Billing, or Claims Processing
* Knowledge of EDI processes, claim submissions, clearinghouses, and rejection management
* Familiar with healthcare insurance payers, claim edits, and reimbursement processes
* Experience using EHR/EMR systems and billing software is preferred
* Strong analytical, problem-solving, and organizational skills
* Excellent communication and coordination skills
* Detail-oriented and able to work in a fast-paced environment
* Open to consultancy contract minimum of 6 months
Perks and Benefits:
* Maternity & Paternity Leave
* Government Contribution (SSS, Pag-ibig, Philhealth)
* 13th Month Pay
* Paid Holidays
* Bereavement Leave
* Paid Vacation Leave
* Paid Sick Leave
* Work from Home
Others:
* Equipment/ company computer is provided
* Night shift differential pay
* Php 1,000 De Minimis
* Php 1,000 monthly bonus upon regularization
* HMO upon regularization
Apply on Vector Outsourcing Solutions Phils. Inc. (opens in a new tab)
Get jobs like this by email
Once a week, we email the new remote jobs open where you live, each with the line that proves it. Every email has a one-click unsubscribe.
