Call Center Agent (Claims Processor-Makati)
TASQ Staffing Solutions Inc.
- Makati City, Metro Manila
- Permanent
- Full-time
- Virtual processing
- Onsite position in Makati
- Dayshift, gliding shift (8am-5pm)
- Production-based incentives on top of salary and benefits (details to be provided by the client)
- Review and analyze medical claims for accuracy, completeness, and eligibility.
- Verify insurance coverage and policy information for each claim.
- Calculate reimbursement amounts based on contract terms, fee schedules, and medical billing guidelines.
- Utilize coding systems as necessary.
- Ensure timely processing of claims within established turnaround times.
- Investigate and resolve any discrepancies or issues, including coordination of benefits, authorization requirements, and prior approvals.
- Communicate with healthcare providers, insurers, and clients to obtain additional information or clarification on claims.
- Follow up on pending claims and outstanding documentation to ensure prompt resolution.
- Maintain accurate records and documentation of all processed claims.
- Adhere to regulations and maintain strict patient confidentiality.
- Stay updated on industry changes, coding updates, and insurance policies to ensure accurate and compliant claim processing.
- Collaborate with team members and provide support as needed to ensure efficient workflow and meet performance metrics.
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