Dental Claims Processing Expert

1 day ago

Marikina City, National Capital Region, Philippines beBeeClaims Full time $60,000 - $70,000

Job Title: Dental Claims Specialist

The ideal candidate for this role will possess strong organizational skills, the ability to work independently and efficiently process and manage claims with attention to detail.

Key Responsibilities:
  • Follow up on outstanding insurance claims ensuring all follow-ups are properly documented and communicated by adding a notation to the patient's account using the track stat and commlog.
  • Send out claims and attachments to insurance companies in a timely manner.
  • Verify denial validity and address them accordingly to ensure claims are processed correctly.
  • Generate OI reports to ensure timely completion and compliance with regulatory requirements.
  • Process claim resubmissions and reprocessing including grievances and appeals in accordance with company policies and procedures.
  • Clear rejected claims on a weekly basis to minimize delays and ensure seamless processing.
  • Update the weekly office tracker to reflect all payments posted (check scans and EFTs) and confirm that all rejected claims were addressed.
  • Complete assigned follow-ups as per office spreadsheets to ensure accuracy and efficiency.
  • Generate EFT reports to retrieve EOBs from insurance portals for 100% posting.
  • Post insurance payments following office preference guidelines and upload EOBs while applying correct adjustments/WOs.
  • Identify and communicate insurance process updates/issues to the team for collaborative resolution.
Requirements:
  • Strong verbal and written English communication skills with minimal accent when speaking.
  • Background in dental insurance or collections industries.
  • Minimum of three years' hands-on collections experience.
  • Highly motivated individual with excellent time management and organizational skills able to work remotely.
  • Outstanding interpersonal and problem-solving skills with a commitment to quality and integrity.

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