Health Claims Specialist

1. Properly adjudicate reimbursement claims on outpatient, inpatient benefits of policyholders on a health policy.2. Accurately determine if a medical condition is a covered benefit based on the policy provisions, terms, and conditions.3. Adjudicate reimbursement claims in accordance with the different processes within defined authority limit and escalate to...

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...

Claims Specialist RoleThe Claims Associate plays a vital role in ensuring seamless claim processing and streamlining the claims management process.This position requires strong organizational skills, attention to detail, effective communication, and proficiency in handling multiple tasks simultaneously.The ideal candidate will possess excellent time...

Job OpportunityWe are seeking an experienced professional to fill a Medical Billing Specialist position within our expanding team.About the RoleVerify patient eligibility and benefits for various treatments, hospitalizations, and procedures.Review and verify patient bills for accuracy and completeness, and obtain any necessary information.Follow up on unpaid...

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, make sure all follow-ups...

Home Health Billing SpecialistWe are seeking a detail-oriented Home Health Billing Specialist to support US-based home health agencies. The ideal candidate will have hands-on experience in processing claims under Medicare, Medicaid, and commercial payers with a strong grasp of PDGM, OASIS, and HIPPS codes.Key Responsibilities:Review and validate clinical and...

Job OverviewMedical Billing SpecialistWe are seeking a highly skilled and detail-oriented Medical Billing Specialist to join our team. As a key member of our operations team, you will play a crucial role in ensuring the accurate and timely processing of medical claims.The ideal candidate will have a strong understanding of medical billing regulations,...

As a professional in the field of claims management, you will play a vital role in maintaining and prioritizing a portfolio of claims on a daily basis. This will ensure timely and accurate processing of these claims.The successful candidate will join a team of professionals based in Manila who are responsible for claim analysis, defense, pursuit, advising,...

Job Title:Dental Claims SpecialistJob Description:We are seeking a highly motivated and organized individual to play a critical role in delivering exceptional service to our customers.The Dental Claims Specialist will be responsible for managing and processing claims, resolving issues, and providing support to our clients while upholding our commitment to...

About the RoleThe Voyage Claims Advisor will join Shell Trading & Supply as a Night Shift role in Manila. The team provides Demurrage and Post Deal Expense claim analysis, defense, pursuit, advice, and settlement on behalf of companies within the North American business.Key ResponsibilitiesMaintain and prioritize a portfolio of claims daily, ensuring timely...