Claims Resolution Expert

3 days ago


Quezon City, National Capital Region, Philippines NTT DATA, Inc. Full time

About the Position

We are seeking a skilled customer service representative to join our team, providing exceptional service to healthcare providers.

Key Responsibilities:

  1. Communicate with healthcare providers to resolve claims issues and provide information on member eligibility and benefits.
  2. Assist providers with navigating the provider portal, including setting up accounts, troubleshooting, and retrieving necessary information.
  3. Handle claim status inquiries, research, and facilitate resolution of payment issues; provider education on remittance advice interpretation and reimbursement.
  4. Work closely with the Claims Team in resolving claims discrepancies, inappropriate denials, and delays in payments.
  5. Provide providers with eligibility, process authorizations, and exception requests.
  6. Answer questions regarding authorizations and denials.

Requirements:

  • Excellent customer service skills, including ability to diffuse difficult situations.
  • Strong analytical and problem-solving skills, with the ability to analyze complex claims data/payments and clearly communicate findings to providers.
  • 1+ year(s) of experience in a service-oriented role where you had to correspond in writing or over the phone with customers who spoke English.


  • Quezon City, National Capital Region, Philippines NTT Data Full time

    The Ideal CandidateWe are looking for a motivated and detail-oriented individual who is passionate about delivering exceptional customer service. As a Provider Liaison Expert, you will play a critical role in building strong relationships with our healthcare provider network.Key Responsibilities:Develop and maintain strong relationships with healthcare...


  • Quezon City, National Capital Region, Philippines Intogreat Solutions Full time

    About the RoleWe are seeking a highly skilled Vehicle Claims Specialist to join our team. As a specialist in this field, you will be responsible for assessing and managing vehicle claims from initial reporting to final resolution.Key Responsibilities:Conduct thorough assessments of damaged vehicles to determine extent of damage and cost of repairs.Develop...


  • Quezon City, National Capital Region, Philippines Polaris Careers Full time

    We are looking for a detail-oriented Healthcare Account Resolution Expert to join our Polaris Careers team. In this role, you will be responsible for resolving customer complaints and concerns in a timely and professional manner, ensuring patient satisfaction and loyalty.Responsibilities:Issue Resolution: Identify and resolve customer complaints and concerns...


  • Quezon City, National Capital Region, Philippines Sourcefit DR Full time

    About the RoleWe are seeking a highly skilled Medical Billing Specialist to join our team at Sourcefit DR. As a key member of our financial team, you will play a crucial role in managing our claims process.Your primary responsibility will be to handle all aspects of claims management, from investigation to resolution. This includes reviewing and analyzing...


  • Quezon City, National Capital Region, Philippines Blue Eagle 525 Lending Investor Inc Full time

    Blue Eagle 525 Lending Investor Inc is seeking a seasoned Debt Resolution Expert to join our team. As a key member of our collection department, you will be responsible for managing and collecting overdue payments from borrowers while maintaining a positive client relationship.Key Accountabilities:Debt Resolution: Resolve outstanding debts through...


  • Mandaluyong City, National Capital Region, Philippines RelianceUnited Full time

    **Job Summary:**We are looking for a skilled Claim Reconciliation Expert to join our team at RelianceUnited. As a key member of our healthcare operations, you will be responsible for processing claims reconciliation requests from accredited Flexicare network providers.**Key Responsibilities:**Process claims records from accredited hospitals and doctors...


  • Quezon City, National Capital Region, Philippines Intogreat Solutions Full time

    About the CompanyWe are Intogreat Solutions, a leading provider of innovative solutions in the automotive industry. Our company is built on a culture of excellence, integrity, and teamwork, and we are committed to delivering exceptional results for our clients.Why Work for Us?We offer a competitive salary package and comprehensive benefits, including health...


  • Quezon City, National Capital Region, Philippines Intogreat Full time

    About UsIn Intogreat, we strive to create a work environment that values our employees' contributions. We foster a culture of work-life balance and recognize the importance of employee satisfaction.Key reasons why you should join us include:We offer a competitive salary package that aligns with industry standards.HMO coverage is provided for you and up to 2...


  • Quezon City, National Capital Region, Philippines Australia and New Zealand Banking Group Limited Full time

    Delinquency Resolution ExpertThis role involves resolving delinquencies and ensuring timely payments for customers. Key responsibilities include:Negotiating payment arrangementsMaximizing promises of paymentAssessing customer needs and implementing solutionsProviding quality customer serviceDocumenting conversations accuratelyRequirementsTo succeed in this...


  • Makati City, National Capital Region, Philippines Neksjob Full time

    Job Overview: Billings Dispute Resolution ExpertNeksjob is looking for a seasoned Billings Dispute Resolution Expert to join our team. As a key member of our financial operations team, you will be responsible for resolving billing disputes, managing accounts payable and accounts receivable, and maintaining accurate financial records.Key...


  • Quezon City, National Capital Region, Philippines Sourcefit DR Full time

    We are a dynamic healthcare company, Sourcefit DR, looking for a skilled Healthcare Claims Specialist to join our team. In this role, you will be responsible for managing the entire claims process from submission to payment.About Our Team:We believe in excellence in all we do and encourage the personal development and professional growth of our team members...


  • Makati City, National Capital Region, Philippines ISTA Solutions Full time

    Job Summary:We are seeking an experienced and detail-oriented Healthcare Claims Processor to join our team at ISTA Solutions. In this role, you will be responsible for managing dental claims from submission to resolution, ensuring timely and accurate approvals.Key Responsibilities:Manage dental claims from submission to resolution, ensuring timely and...


  • Quezon City, National Capital Region, Philippines Manpower Core Group Inc. Full time

    Work with UsWe are looking for a skilled Medical Billing Specialist to join our team at Manpower Core Group Inc. This role offers an exciting opportunity to work in a dynamic environment where you will be responsible for managing patient accounts, resolving claim denials, and providing exceptional customer service.ResponsibilitiesThe successful candidate...


  • Makati City, National Capital Region, Philippines UnitedHealth Group Full time

    Job DescriptionProvide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities.Analyze, identify trends, and provide reports as necessary.Ensure adherence to state and federal compliance policies,...


  • Quezon City, National Capital Region, Philippines UnionBank of the Philippines Full time

    Job DescriptionWe are seeking an experienced Transaction Monitoring Expert to join our team. As a key member of our operations team, you will play a critical role in ensuring the smooth operation of our credit card business.Main Responsibilities:Your primary responsibilities will include:Monitoring and analyzing card transactions for potential...

  • Debt Resolution Expert

    14 hours ago


    Quezon City, National Capital Region, Philippines VICS CONSTRUCTION & SONS CO. Full time

    Key Responsibilities:Oversee the entire accounts receivable process, from initial contact to final payment resolution.Analyze customer data to identify patterns and trends in payment behavior, informing the development of targeted collection strategies.Negotiate payment arrangements with customers who are experiencing financial difficulties, working to find...


  • Makati City, National Capital Region, Philippines Trinity Workforce Solutions Full time

    Trinity Workforce Solutions OverviewAt Trinity Workforce Solutions, we pride ourselves on delivering exceptional service and support to our clients. Our team is dedicated to helping organizations achieve their goals, and we're always looking for talented individuals to join us.Job DescriptionThe role involves managing claims administration by preparing and...


  • Makati City, National Capital Region, Philippines Institutional Shareholder Services Inc. Full time

    Institutional Shareholder Services Inc. seeks an Unapplied Cash Resolution Expert to join their team.This expert will be responsible for managing, controlling, and resolving unapplied or unidentified customer deposits, payments, and account balance issues.About the Role:This Financial Transaction Manager will be primarily responsible for identifying,...


  • Mandaluyong City, National Capital Region, Philippines RelianceUnited Full time

    Job Objective / Purpose The Claim Reconciliation Processor is responsible for processing the account reconciliation requests from the accredited Flexicare network. S/He plays an important role in ensuring that all reconciliations assigned are completed accurately and on time. This role will be hired under Flexicare, Health Delivery System, Inc. (HDSI) - a...


  • Quezon City, National Capital Region, Philippines Sourcefit DR Full time

    **About the Role**We are looking for a highly skilled Healthcare Coding Expert to join our team.The ideal candidate will have experience with medical billing software and electronic health record (EHR) systems.Key responsibilities include processing and submitting medical claims accurately, maintaining compliance with US healthcare billing regulations, and...