Professional Insurance Claim Resolution Specialist

2 days ago

Caloocan City, National Capital Region, Philippines beBeeDentalClaimsSpecialist Full time ₱600,000 - ₱850,000

Role Summary:

As a Dental Claims Specialist, you will play a critical role in delivering exceptional service to our customers. You will be responsible for managing and processing claims, resolving issues, and providing support to our clients while upholding our commitment to quality and integrity.

  • Follow-up status of outstanding insurance claims, ensure all follow-ups are properly documented and communicated by adding a notation to the patient's account using the track stat and commlog.
  • Send out claims and attachments to insurance companies.
  • Determine denial validity and address them properly.
  • Generate OI reports and complete them monthly.
  • Claim resubmission and reprocessing, including grievance and appeals.
  • Clear rejected claims on a weekly basis.
  • Update the office tracker to include all payments posted (check scans and EFTs) and ensure all rejected claims were addressed.
  • Complete all assigned follow-ups (on the office spreadsheets).
  • Generate EFT reports and retrieve EOBs from insurance portals for posting 100%.
  • Post insurance payments according to the office preference, always uploading the EOB and applying the correct adjustment/WO.
  • Identify insurance process updates/issues and communicate findings with the team regarding open insurance matters.
  • Remain professional at all times, observing work ethics and adhering to the work schedule.
  • Achieve desired goals and accomplish tasks in a timely manner.
  • Communicate with the manager in the absence of attendance issues.
Requirements
  • Strong command of verbal and written English and interpersonal skills with minimal accent when speaking.
  • Background in the dental insurance or collections industries.
  • At least 3 years of hands-on collections experience.
  • Highly motivated, detail-oriented individual able to work independently as this is a remote position.
  • Outstanding organizational, time management, and follow-up skills.
  • Health maintenance organization (HMO) with 1 free dependent upon hire (with dental coverage).
Benefits

This role offers a comprehensive benefits package including health, dental, and vision coverage.

Additionally, employees may take advantage of flexible work arrangements and ongoing training opportunities.

Work Environment

As a remote employee, you will work independently in your home office with regular check-ins and collaboration with colleagues through digital communication tools.

The ideal candidate will be self-motivated and able to prioritize tasks effectively in a fast-paced environment.

  • Insurance Claim Resolution Specialist

    2 days ago

    Marikina City, National Capital Region, Philippines beBeeAnalyzer Full time $35,000 - $45,000

    Medical Biller AR Followup AnalystClinicMind is seeking a Medical Biller AR Followup Analyst to work from home. As the nation's leader in multi-specialty Electronic Healthcare Records software and Revenue Cycle Management services, we're looking for individuals who are excited to be part of a winning team.As a Medical Biller AR Followup Analyst, you will...

  • Claim Resolution Specialist

    1 week ago

    Quezon City, National Capital Region, Philippines Stark Asia Solutions, Inc Full time ₱436,000 per year

    The Claim Resolution Specialist plays a versatile role in the claims workflow, tasked with submitting appeals to overturn denials and trigger payments or determining whether further action, such as additional appeals or account closure, is required. Specialists in this role may prioritize tasks based on claim complexity and workload, ensuring optimal...

  • Remote Claims Resolution Specialist

    2 days ago

    Caloocan City, National Capital Region, Philippines beBeeClaims Full time ₱35,000

    Remote Claims Resolution SpecialistThe Remote Claims Resolution Specialist will be responsible for investigating and resolving customer claims related to branded and imprinted merchandise. These claims may include imprinting errors, delivery delays, pricing discrepancies, incorrect products, or issues affecting overall product quality and integrity.Key...

  • Claims Resolution Specialist

    2 weeks ago

    Makati City, National Capital Region, Philippines beBeeClaimsResolution Full time ₱900,000 - ₱1,200,000

    Job DescriptionWe are seeking a Claims Resolution Specialist to join our team. This role involves reviewing, researching and resolving claims for health plans, commercial customers and government entities.As a Claims Resolution Specialist, you will be responsible for analyzing and identifying trends and providing reports as necessary. You will also ensure...

  • Medical Insurance Claim Resolution Specialist

    2 days ago

    Makati City, National Capital Region, Philippines beBeeReimbursement Full time ₱350,000 - ₱500,000

    Job OverviewClinicMind is seeking a skilled Medical Biller AR Follow-up Analyst to maximize insurance reimbursement for healthcare practice owners. This role involves identifying the root causes of medical insurance claim denials, underpayments, or delays and proposing resolutions.Key Responsibilities:Optimize insurance reimbursement for healthcare practice...

  • Insurance Claims Specialist

    1 week ago

    Makati City, National Capital Region, Philippines beBeeClaimsResolution Full time ₱900,000 - ₱1,200,000

    Claims Resolution SpecialistWe are seeking a skilled Claims Resolution Specialist to join our team. In this role, you will be responsible for processing claims, providing recommendations and final decisions based on set authority limits approved by management.About the RoleThis position involves coordinating with team members and other stakeholders to ensure...

  • Medical Insurance Claim Analyst

    2 days ago

    Caloocan City, National Capital Region, Philippines beBeeInsurance Full time $45,000 - $57,000

    Job OpportunityWe are seeking a Medical Insurance Claim Analyst to optimize insurance reimbursement for healthcare providers. This role involves investigating root causes for medical insurance claim denial, underpayment, or delay and proposing resolutions.Key ResponsibilitiesOptimize insurance reimbursement for healthcare providersInvestigate root causes for...

  • Claim Resolution Professional

    7 days ago

    Makati City, National Capital Region, Philippines beBeeReimbursement Full time $56,640 - $75,152

    Medical Billing Specialist OpportunityWe are seeking a detail-oriented Medical Billing Specialist to support the revenue cycle operations of our healthcare client.This role is primarily focused on reducing claim denials and recovering aging or stale claims.You will be working directly in our clients billing system, managing claim queues, and communicating...

  • Claims Resolution Specialist

    2 days ago

    Mandaluyong City, National Capital Region, Philippines beBeeClaimsResolution Full time ₱720,000 - ₱780,000

    Job SummaryA Claims Resolution Specialist is responsible for reviewing and evaluating customer claims, ensuring their accuracy, eligibility, and compliance with company policies. This involves investigating claims, determining validity, and customer settlement amounts while maintaining detailed records and communicating with team leads for approval.Key...

  • Claims Resolution Specialist

    2 days ago

    Marikina City, National Capital Region, Philippines beBeeClaims Full time ₱35,000

    Delegate CX is seeking a highly skilled and detail-oriented Claims Representative to join its team.Job Description:The role of the Claims Representative will be to investigate and resolve customer claims related to branded and imprinted merchandise.Responsibilities:Investigate incoming customer claims related to promotional product orders.Collaborate with...