Description

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