Verification and Claims Specialist
2 days ago
As a Verification and Claims Specialist, you will play a critical role in confirming insurance coverage, estimating patient financial responsibilities, and determining the coverage of specific services, devices, and treatment modalities under patients' insurance plans.
This position requires strong analytical skills, attention to detail, and excellent communication skills. You will work closely with healthcare providers, billing staff, and administrative personnel to ensure seamless coordination of insurance verification processes.
The ideal candidate will have a deep understanding of insurance benefits and coverage, as well as experience in resolving benefits and verification issues. They will also be proficient in using electronic systems for insurance verification and have exceptional problem-solving skills.
Main Responsibilities:- Insurance Verification: Verify patients' insurance coverage and eligibility through electronic systems or direct communication with insurance providers.
- Review insurance policies, benefit summaries, and pre-authorization requirements to determine coverage for medical services, devices, and treatment modalities.
- Update patient records with verified insurance information and coverage details.
- Financial Estimation: Estimate patients' out-of-pocket expenses, including co-pays, deductibles, and co-insurance, for planned medical services or procedures.
- Communicate cost estimates to patients, explaining their financial responsibilities and payment options.
- Coverage Determination: Investigate and determine if specific medical services, devices, or treatment modalities are covered under patients' insurance plans.
- Liaise with insurance companies to obtain pre-authorizations and prior approvals for procedures or treatments when necessary.
- Advise healthcare providers and patients on coverage limitations and alternative payment options for non-covered services.
- Documentation and Reporting: Maintain accurate records of insurance verifications, coverage determinations, and patient cost estimates.
- Generate reports on insurance verification outcomes, coverage trends, and reimbursement issues to support decision-making and process improvement.
- Strong verbal and written communication skills
- Expert understanding of insurance benefits and coverage
- Understanding of insurance web portals
- Problem solving minded/focused
- Minimum 2 years of experience in benefits and verification Resolution focused and driven mindset
-
Insurance Verification Specialist
1 day ago
Cebu City, Central Visayas, Philippines beBeeVerification Full time ₱49,000 - ₱74,000Job Title: Insurance Verification SpecialistAbout the Role:The Insurance Verification Specialist plays a pivotal role in ensuring seamless patient admissions, billing, and claims processes by verifying insurance coverage and benefits.This position requires strong communication skills, medical terminology knowledge, and an understanding of insurance...
-
Medical Claims Specialist
2 days ago
Cebu City, Central Visayas, Philippines beBeeClaims Full time ₱400,000 - ₱800,000Job Summary:We are seeking a highly skilled Medical Claims Specialist to join our team.About the Role:This is a unique opportunity for a detail-oriented professional to utilize their analytical skills in insurance verifications, claim coding and submission.Key Responsibilities:Verify insurance details for patients online and via phone calls to ensure timely...
-
Healthcare Claims Processor
6 days ago
Cebu City, Central Visayas, Philippines beBeeBilling Full time ₱500,000 - ₱800,000Medical Billing SpecialistThe Medical Billing Specialist plays a vital role in the healthcare revenue cycle, ensuring accurate and timely processing of medical claims. They are responsible for preparing and submitting accurate medical claims to insurance payers, adhering to coding and billing standards.Key Responsibilities:Claim Preparation: Prepare medical...
-
Medical Claims Coordinator
6 days ago
Cebu City, Central Visayas, Philippines beBeeClaims Full time ₱2,400,000 - ₱4,200,000Medical Claims Specialist Job DescriptionThe Medical Claims Specialist plays a pivotal role in ensuring the accurate submission of medical claims to insurance companies and effectively managing accounts receivable.This specialist is responsible for preparing and submitting medical claims, adhering to coding guidelines such as CPT, ICD-10, and HCPCS. They...
-
Medical Claims Specialist
1 day ago
Cebu City, Central Visayas, Philippines beBeeClaims Full time ₱50,000 - ₱79,000Medical Claims CoordinatorThe Medical Claims Coordinator plays a vital role in ensuring accurate and timely medical claims submissions to insurance companies.This position requires strong knowledge of medical billing and coding processes, as well as effective communication skills for interacting with patients and insurers.Key Responsibilities:Claim...
-
Eligibility and Verifications Specialist
2 weeks ago
Cebu City, Central Visayas, Philippines CallTek Full timeOverviewSummary: An Eligibility and Verifications Specialist's main responsibilities include verifying insurance coverage, estimating patient cost-sharing responsibilities, and determining the coverage of specific services, devices, and treatment modalities under patients' insurance plans. Your expertise will ensure accurate billing, streamline...
-
Eligibility and Verifications Specialist
2 days ago
Cebu City, Central Visayas, Philippines Staff4Me Full timeSummary:An Eligibility and Verifications Specialist's main responsibility is verifying insurance coverage, estimating patient cost-sharing responsibilities, and determining the coverage of specific services, devices, and treatment modalities under patients' insurance plans. Your expertise will ensure accurate billing, streamline administrative processes, and...
-
Lead Verification Specialist
1 day ago
Cebu City, Central Visayas, Philippines beBeeVerification Full time $40,000 - $60,000Lead Verification Support Specialist OpportunityEmbark on a rewarding career in a multicultural and multilingual environment as a Lead Verification Support Specialist for a prestigious brand.Job SummaryConfirm lead interest by establishing contact and verifying informationForward qualified inquiries to authorized retailersUpdate and categorize leads within...
-
Claim Specialist
2 days ago
Cebu City, Central Visayas, Philippines beBeeLogistics Full time ₱5,040,000 - ₱8,640,000Claims and Logistics Specialist RoleThis is a challenging opportunity to work as a Claims and Logistics Specialist in a fast-paced environment. The ideal candidate will have strong organizational skills, attention to detail, and excellent communication skills.Key Responsibilities:Manage multiple workflows simultaneously.Process and assess claims, recoveries,...
-
Claims Specialist
1 week ago
Cebu City, Central Visayas, Philippines beBeeCustomerService Full time ₱800,000 - ₱1,200,000Job Title">We are seeking a dedicated Claims Specialist to join our team. As a Claims Specialist, you will play a vital role in managing customer contacts and resolving concerns in a timely and efficient manner.">About the Role">This is an exciting opportunity for someone who is passionate about delivering exceptional customer service and has strong...
