Back-Office CSR

4 weeks ago

Mandaluyong City, National Capital Region, Philippines ISTA Personnel Solutions Full time
Overview

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you

Responsibilities

Account specific roles and responsibilities

Census Management:

  • Review and process the daily Census report from the Prior Authorization Department, including new admissions and patient transfers.
  • Cross-reference patient information with the Medicaid portal to determine whether authorizations are required.
  • Accurately enter all patient data regardless of authorization status.
  • Tag and flag cases that require authorization for tracking and escalation.

Authorization Follow-up:

  • Identify and follow up on authorizations that have been pending for over 30 days.
  • Contact insurance companies directly to obtain status updates and clarify where the case is pending in the review process.
  • Document all communication and update case statuses in the system accordingly.
    • At least 6 months BPO experience handling US Healthcare Insurance
    • Preferably with long term care, census, or authorizations experience
    • Familiar with MS Tools (Word, Excel, Outlook)
      • Good verbal and written English skills
      • Must be willing to work on-site in Mandaluyong
      • Amenable working night shifts
      QualificationsBenefits
      • Competitive salary and benefits
      • Health Insurance with free dependents*
      • 10%-night differential
      • Attendance Bonus
      • Paid time off
      • Convertible to cash leave credits
      • Performance Appraisal
      • Work-life balance
      • A focus on growing your career path with us
      • We encourage you to follow your passions and learn new skills
      Our commitment to you
      • Strong culture and values-driven leadership
      • We create opportunities for you to learn and grow at any stage of your career
      • Continuous learning and innovation
      • We foster an all inclusive environment where everyone thrives

      #J-18808-Ljbffr

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