Senior Insurance Claim Adjuster

2 days ago

Cebu City, Central Visayas, Philippines beBeeDentalClaims Full time ₱2,500,000 - ₱4,000,000

Dental Claims Specialist Role

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

This is a key position that requires strong organizational and time management skills, as well as the ability to work independently in a remote setting.

  • Key Responsibilities:
  • 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.
  • Determine denial validity and address them properly.
  • Generate OI reports and ensure monthly completion.
  • Claim resubmission and reprocessing, including grievance and appeals.
  • Clear rejected claims on a weekly basis.
  • Update weekly office tracker to include all payments posted (check scans and EFTs) and if all rejected claims were addressed.
  • Complete all follow-ups assigned.
  • Generate EFT reports and retrieve EOBs from insurance portals for posting 100%.
  • Insurance payment posting - follow office preference, always upload EOB, and apply correct adjustment/WO.

Requirements

  • Skill Requirements:
  • Strong command of verbal and written English and interpersonal skills.
  • Background in the Dental insurance or collections industries.
  • 3+ years of hands-on collections experience.
  • Highly motivated, detail-oriented, able to work independently.
  • Outstanding organizational, time management and follow-up skills.

Benefits

We offer a highly competitive compensation package, including HMO with 1 free dependent upon hire (with Dental coverage).

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