Claims Resolution Specialist

1 day ago

Pasig, National Capital Region, Philippines beBeeClaims Full time ₱250,000 - ₱450,000

Job Title:

Claims Resolution Specialist

Description:

We are seeking a detail-oriented and organized individual to support our Collections and/or Denial Management department. The successful candidate will be responsible for gathering and disseminating information from hospitals and insurance companies related to referred claims.

Responsibilities:

  • Verify member benefits, effective dates, claims, and appeal information with insurance companies.
  • Research claims and insurance information through hospital/state databases.
  • Organize time frames in which claims must be appealed.
  • Use Microsoft Outlook to set follow-up reminders.
  • Provide daily/weekly updates to management.
  • Ensure the confidentiality, integrity, and availability of patients' protected health information (PHI) in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

Requirements:

  • A High School diploma or equivalent is required.
  • Experience with EAGLE, NAVI-Net, Epic, and I-SUITE is an asset.
  • Proficiency in Microsoft Office applications (Word, Excel, and Outlook) is essential.
  • The ability to communicate effectively with external contacts, including insurance company representatives, is necessary.
  • Solid data entry skills and the ability to learn proprietary databases are required.
  • Strong verbal and written communication skills are essential.
  • Strong organization and time-management skills, as well as the ability to work in a fast-paced environment, are necessary.
  • Solid investigative skills and a persistent demeanor are required.
  • Reliability, attention to detail, resourcefulness, and analytical thinking are essential qualities for this role.

Working Conditions:

  • This is an onsite position with a night shift schedule.
  • The noise level in the work environment is generally minimal.

We are committed to creating a diverse and inclusive work environment and are an equal opportunity employer.

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