Insurance Claims Examiner

16 hours ago

Cavite City, Calabarzon, Philippines beBeeDentalClaimsSpecialist Full time ₱520,000 - ₱730,000
Dental Claims Specialist

As a key member of our team, you will be responsible for managing and processing claims, resolving issues, and providing exceptional support to our clients while upholding our commitment to quality and integrity. We are seeking a highly motivated and detail-oriented individual with strong communication skills to join our team in this critical role.

Key Responsibilities:

  • Follow-up on outstanding insurance claims, ensuring all follow-ups are properly documented and communicated by adding a notation to the patient's account using our track stat and commlog system.
  • Send claims and attachments to insurance companies.
  • Determine denial validity and address them accordingly.
  • Generate OI reports and ensure timely completion each month.
  • Resubmit and reprocess claims, including grievances and appeals.
  • Clear rejected claims on a weekly basis.
  • Update the weekly office tracker to include all payments posted and verify that all rejected claims have been addressed.
  • Complete assigned follow-ups from the office spreadsheets.
  • Generate EFT reports and retrieve EOBs from insurance portals for posting 100% accuracy.
  • Post insurance payments according to office preference, always upload EOBs, and apply correct adjustments or withdrawals.
  • Identify insurance process updates or issues and communicate findings with the team to ensure seamless operations.
  • Maintain professionalism at all times, adhering to work ethics and schedules.
  • Achieve desired goals and complete tasks in a timely manner.
  • Communicate effectively with managers in the absence of any attendance issues.
Requirements:
  • Strong verbal and written English skills, with minimal accent when speaking.
  • Background in 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.
Benefits:
  • The opportunity to work with a dynamic team and contribute to the success of our organization.
  • A competitive salary and benefits package.

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