Professional Insurance Claim Adjuster

1 day ago


Las Piñas, National Capital Region, Philippines beBeeClaims Full time ₱650,000 - ₱850,000
Job Title: Dental Claims Specialist

This role involves providing exceptional service to customers by managing and processing claims, resolving issues, and offering support while upholding quality and integrity.

  • 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.
  • Determine denial validity and address them properly.
  • Generate OI reports and ensure monthly completion.
  • Resubmit and reprocess claims, including grievances and appeals.
  • Clear rejected claims on a weekly basis.
  • Update the weekly office tracker to include all payments posted (check scans and EFTs) and confirm all rejected claims were addressed.
  • Complete assigned follow-ups (on the office spreadsheets).
  • Generate EFT reports and retrieve EOBs from insurance portals for posting 100%.
  • Post insurance payments following office preference, uploading EOBs and applying correct adjustments/WOs.
  • Identify insurance process updates/issues and communicate findings with the team that insurances are open while working.
  • Remain professional at all times, observing work ethics and adhering to the work time schedule.
  • Achieve desired goals and accomplish tasks in a timely manner.
  • Communicate with managers in the absence of attendance issues.


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