Claims Processing Specialist

1 day ago

Cabuyao, Calabarzon, Philippines beBeeClaims Full time ₱450,000 - ₱650,000
Dental Claims Specialist">

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

  • Follow-up the 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.
  • Process claim resubmission and reprocessing, including grievances and appeals.
  • Clear rejected claims on a weekly basis.
  • Update the weekly office tracker to include all payments posted (check scans and EFTs) and verify that 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 office preference, always upload EOBs, and apply correct adjustments or work orders.
  • Identify any insurance process updates/issues and communicate findings with the team regarding open insurances while working.
  • Required to maintain professionalism at all times, adhering to work ethics and observing work time schedules.
  • Expected to meet desired goals and accomplish tasks in a timely manner.
  • Expected to communicate with the manager in case of absence due to attendance issues.
">Requirements
  • Strong command of verbal and written English and interpersonal skills, minimal accent when speaking.
  • Background in the Dental insurance or collections industries.
  • At least 3 years of hands-on experience in collections.
  • Highly motivated, detail-oriented, and able to work independently as this is a remote position.
  • Outstanding organizational, time management, and follow-up skills.
  • HMO coverage with 1 free dependent upon hire.

The ideal candidate will possess excellent communication and problem-solving skills, along with a strong attention to detail and ability to work independently in a fast-paced environment.

The selected candidate will be required to sign confidentiality agreements and adhere to company policies and procedures.

A background check and drug screening may be conducted prior to hiring.

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