Healthcare Claims Specialist
1 day ago
ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you
Account Specific Roles and Responsibilities:
- Review and process ambulance insurance claims, ensuring accuracy and compliance with client and insurance requirements
- Work directly with clients to address inquiries, provide updates, and resolve claim-related concerns
- Verify claim details including eligibility, coverage, and supporting documentation
- Apply knowledge of medical and diagnosis codes to ensure correct claim submission and adjudication
- Identify and escalate discrepancies, denials, and appeals as needed
- Maintain accurate and timely claim records in line with company and client standards
- Uphold confidentiality and compliance with HIPAA guidelines
Requirements
- At least 6 months of Healthcare experience
- Above average verbal and written English communication skills
- Medical claims and prior authorization experience preferred but not required
- Knowledge of medical and diagnosis codes is required
- Strong attention to detail with a focus on accuracy
- Ability to work independently while managing multiple tasks
- Willing to work onsite in Mandaluyong
- Amenable working night shift
Benefits
What Can We Offer You?
- Competitive salary and benefits
- Health Insurance with free dependents
- 10%-night differential
- Attendance Bonus
- Paid Time Off
- Convertible to Cash Leave Credits
- Performance Appraisal
- Work-life Balance
- A focus on growing your career path with us
- We encourage you to follow your passions and learn new skills
Our Commitment To You
- Strong culture and values-driven leadership
- We create opportunities for you to learn and grow at any stage of your career
- Continuous learning and innovation
- We foster an all-inclusive environment where everyone thrives
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