Customer Service Representatives

1 day ago

Ormoc City, Eastern Visayas, Philippines Virtual Staffing Solutions Full time $40,000 - $60,000 per year
Description

Virtual Staffing Solutions is seeking for Claims and Eligibility Representatives to join our growing team. In this role, you will be responsible for verifying patient eligibility, processing healthcare claims, and ensuring compliance with payer guidelines. You will play a critical role in maintaining accuracy and efficiency while delivering exceptional service to members, providers, and payers.

Key Responsibilities
  • Verify patient eligibility and benefits through payer portals and systems.
  • Accurately process, review, and update healthcare claims in accordance with CPT/ICD coding and payer guidelines.
  • Ensure completeness and accuracy of data entry, records, and documentation.
  • Research and resolve claim or eligibility discrepancies in a timely manner.
  • Collaborate with providers, payers, and internal teams to clarify benefits and resolve claim issues.
  • Maintain compliance with HIPAA regulations and organizational policies.
  • Provide clear and professional communication to stakeholders regarding claim and eligibility status.
  • Contribute to process improvements and support team goals in a fast-paced environment.
Skills, Knowledge & Expertise
  • Familiarity with medical terminology, CPT/ICD codes, and healthcare payer guidelines preferred but required.
  • Background in healthcare administration, customer service, or a related field is a plus.
  • Strong attention to detail with a high level of accuracy in data entry and recordkeeping.
  • Proficiency in MS Office applications and claims/eligibility systems.
  • Excellent communication, interpersonal, and problem-solving skills.
  • Ability to work independently as well as collaboratively in a team setting.
  • Prior experience in claims processing, medical billing, or healthcare eligibility is an advantage.
About Virtual Staffing Solutions

We specialize in delivering innovative solutions and exceptional services to meet the diverse needs of our clients. With a strong commitment to quality and customer satisfaction, we strive to exceed expectations and drive success in every project we undertake.

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