Expert Insurance Claims Resolution Professional

18 hours ago

Manila, National Capital Region, Philippines beBeeClaims Full time ₱3,500,000 - ₱5,500,000
Dental Claims Specialist Job Description

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 to our clients while upholding our commitment to quality and integrity.

  • Follow-up status of outstanding insurance claims, ensuring all follow-ups are properly documented and communicated by adding notations to the patient's account using track stats and communication logs.
  • Send out claims and attachments to insurance companies.
  • Determine denial validity and address them properly.
  • Generate Operational Insight reports and ensure monthly completion.
  • Claim resubmission and reprocessing, including grievances and appeals.
  • Clear rejected claims on a weekly basis.
  • Update the weekly office tracker with all payments posted (check scans and Electronic Funds Transfers) and confirm that all rejected claims were addressed.
  • Complete all follow-ups assigned on office spreadsheets.
  • Generate Electronic Funds Transfer reports and retrieve Explanation of Benefits from insurance portals for 100% posting.
  • Post insurance payments according to office preference, always upload Explanation of Benefits, and apply correct adjustments or Work Orders.
  • Identify any insurance process updates or issues and communicate findings with the team while insurances remain open.
  • 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.
  • Communicate with managers in the absence of attendance issues.

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