ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Claims Specialist 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 & responsibilities:
- Review and analyze denied claims to determine root causes and appropriate next steps
- Address and resolve claims based on the most common denial reasons as well as unique or complex scenarios
- Navigate multiple billing and payer portals to gather claim information and submit corrections or appeals
- Contact insurance companies via phone or online systems to clarify denial details and follow up on claim status
- Prepare and submit appeals, corrected claims, or additional documentation as required
- Track and document all actions taken on claims for accurate record-keeping
- Identify trends in denials and escalate recurring issues when necessary
Requirements
- 6 months - 1 year BPO experience in a US Healthcare Account
- Good working knowledge with Claims and Denials
- Excellent verbal & written English skills
- Strong problem-solving skills
- Adaptability to a changing work environment
- Ability to remain calm under pressure
- Proficiency in using computer systems & relevant software
- Willing to work onsite in in Shaw Blvd, 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