Insurance Claims Processor

2 weeks ago


Porac, Philippines beBeeClaims Full time ₱400,000 - ₱550,000
Dental Claims Specialist Role Overview

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 while upholding our commitment to 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.
  • Determine denial validity and address them properly.
  • Generate OI reports and ensure monthly completion.
  • Resubmit and reprocess claims, including grievances and appeals.
  • Clear rejected claims on a weekly basis.
  • Update the weekly office tracker with payments posted (check scans and EFTs) and confirmed addressed rejected claims.
  • Complete all assigned follow-ups on office spreadsheets.
  • Generate EFT reports and retrieve EOBs from insurance portals for posting at 100%.
  • Post insurance payments following office preference, uploading EOBs and applying adjustments/correcting WOs.
  • Identify insurance process updates/issues and communicate findings with the team regarding open insurances.
  • Remain professional at all times, adhering to work ethics and maintaining the work schedule.
  • Achieve desired goals and accomplish tasks in a timely manner.
  • Communicate with the manager in the absence of attendance issues.
Requirements:
  • Strong verbal and written English skills, along with excellent interpersonal skills and 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.


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