Senior Insurance Claims Examiner

1 day ago

Taguig, National Capital Region, Philippines beBeeInsuranceVerification Full time ₱900,000 - ₱1,200,000
Insurance Verification Supervisor

Customer Service Operations is responsible for providing outsourced services to customers relating to medical billing, medical reimbursement, and/or other services by acting as a liaison in problem-solving, research and problem/dispute resolution.

The Insurance Verification Supervisor assists the Insurance Verification Manager in overseeing the insurance verification process, ensuring efficient and accurate verification of patient insurance coverage and authorizations. They provide direct supervision to a team of insurance verification specialists, supporting their development and ensuring adherence to established procedures and standards.

  • Supervises and supports a team of insurance verification specialists, fostering a collaborative and positive work environment conducive to achieving team goals.
  • Provides training, coaching, and mentorship to team members to enhance their skills and performance, identifying areas for improvement and implementing strategies to address them.
  • Collaborates with the Insurance Verification Manager to implement improvements and address areas for enhancement, conducting regular audits to ensure accuracy and compliance.
  • Monitors authorization status and escalates issues as necessary to ensure timely approvals, communicating effectively with cross-functional teams to resolve issues and achieve goals.
  • Collaborates with billing and coding teams to address insurance-related claim rejections and denials, analyzing data and trends to identify areas for improvement.

Assists in investigating and resolving discrepancies in insurance coverage and billing information, using analytical skills to anticipate outcomes and make informed decisions.

Conducts regular training sessions and provides ongoing support to ensure team members are proficient in insurance verification procedures and software, encouraging continuous learning and skill enhancement within the team.

Identifies training needs and opportunities for professional development among team members, creating a supportive and inclusive work environment that promotes growth and advancement.

Collaborates with the Insurance Verification Manager to develop and implement standardized procedures for insurance verification, ensuring consistency and accuracy throughout the process.

Oversees the verification of patient insurance coverage, ensuring accuracy and timeliness, and communicates with insurance companies to obtain authorizations and resolve authorization-related issues.

Requirements

Internal:

  • No disciplinary actions for the past 12 months.
  • At least 1 year of tenure in current role.
  • Knowledge in Healthcare Operations specifically Insurance Verification is required.

External:

  • At least 2 years of college coursework or experience.
  • 2 years of Leadership experience.
  • Knowledge in Healthcare Operations specifically Insurance Verification is required.
  • Experience in using Contact Center phone system such as NICE and/or Genesys is an advantage.
Benefits

This position offers a competitive salary and benefits package, including professional growth opportunities, a supportive work environment, and the chance to make a meaningful impact in the lives of others.

Other Responsibilities

May perform any additional responsibilities or special projects as required, and may provide cross-functional support as business needs demand.

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