Claims Resolution Specialist Position

2 days ago


Angeles City, Central Luzon, Philippines beBeeClaims Full time ₱250,000 - ₱450,000

Claims Resolution Expert

As a Claims Resolution Expert, you will play a crucial role in delivering exceptional service to our customers. You will be responsible for managing and processing claims, resolving issues, and providing support while upholding quality and integrity.

  • Monitor the status of outstanding insurance claims and document follow-ups, ensuring timely communication with clients.
  • Send claims and attachments to insurance providers.
  • Determine denial validity and address them accordingly.
  • Generate OI reports and ensure monthly completion.
  • Resubmit and reprocess claims, including grievance and appeals.
  • Clear rejected claims on a weekly basis.
  • Update the office tracker with payments posted (check scans and EFTs) and address all rejected claims.
  • Complete assigned follow-ups on office spreadsheets.
  • Retrieve EOBs from insurance portals for posting and apply adjustments correctly.
  • Identify insurance process updates/issues and communicate findings with the team.
  • Remain professional at all times, adhering to work ethics and schedules.
  • Meet desired goals and accomplish tasks efficiently.
  • Communicate with managers regarding attendance and performance.
Requirements
  • Excellent verbal and written English skills, 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.
  • Competitive benefits package, including HMO coverage with 1 free dependent.


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