Dental Claims Professional

1 day ago

Mandaue City, Central Visayas, Philippines beBeeClaimsSpecialist Full time ₱375,000 - ₱425,000

We are seeking a highly skilled Dental Claims Specialist to manage and process claims, resolve issues, and provide support while maintaining our commitment to quality and integrity.

  • Follow-up status of outstanding insurance claims and ensure all follow-ups are properly documented and communicated.
  • Send out claims and attachments to insurance companies for timely processing and resolution.
  • Determine denial validity and address them appropriately to minimize delays.
  • Generate OI reports and ensure monthly completion to track performance and identify areas for improvement.
  • Claim resubmission and reprocessing, including grievance and appeals, to ensure fair outcomes.
  • Clear rejected claims on a weekly basis to maintain efficient claim handling.
  • Update weekly office tracker with payments posted and rejected claims addressed to ensure transparency and accountability.
  • Complete all follow-ups assigned to ensure prompt action and resolution.
  • Generate EFT reports and retrieve EOBs from insurance portals for accurate payment posting.
  • Insurance payment posting - follow established procedures and upload EOBs with correct adjustments.
  • Identify insurance process updates/issues and communicate findings to the team to ensure informed decision-making.
Requirements:
  • Strong command of verbal and written English and interpersonal skills to effectively interact with customers and colleagues.
  • Background in the Dental insurance or collections industries to leverage relevant experience and knowledge.
  • 3+ years of hands-on collections experience to demonstrate expertise and proficiency.
  • Highly motivated, detail-oriented, able to work independently in a remote position with minimal supervision.
  • Outstanding organizational, time management, and follow-up skills to prioritize tasks and meet deadlines.

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