Dental Insurance Process Manager

1 day ago

Cebu City, Central Visayas, Philippines beBeeClaims Full time ₱1,500,000 - ₱2,500,000
Dental Claims Specialist

In this role, you will play a critical part in delivering top-notch service to our customers. Your primary responsibility will be managing and processing claims, resolving issues, and providing support while maintaining the highest level of quality and integrity.

Key Responsibilities:
  • Follow-up status of outstanding insurance claims, ensuring 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 appropriately.
  • Generate OI reports and ensure monthly completion.
  • Claim resubmission and reprocessing, including grievance and appeals.
  • Clear rejected claims on a weekly basis.
  • Update the weekly office tracker to include all payments posted, check scans, and EFTs, verifying that all rejected claims were addressed.
  • Complete all follow-ups assigned on the office spreadsheets.
  • Generate EFT reports and retrieve EOBs from insurance portals for posting 100%.
  • Post insurance payments following the office preference, uploading EOBs and applying corrections as needed.
  • Identify any insurance process updates or issues and communicate findings with the team.
  • Remain professional at all times, observing work ethics and adhering to the work time schedule.
  • Achieve desired goals and accomplish tasks in a timely manner.
Requirements:
  • Strong command of verbal and written English and interpersonal skills, with little to no accent when speaking.
  • Background in the dental insurance or collections industries.
  • At least 3 years of hands-on collections experience.
  • Highly motivated, detail-oriented, and able to work independently, as this is a remote position.
  • Outstanding organizational, time management, and follow-up skills.
  • A HMO plan with one free dependent upon hire, with dental coverage.

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