Healthcare Claims Specialist — Night Shift & Benefits

ISTA Solutions; Mandaluyong; On-site; PHP 201,000 - 312,000; Full time

Benefits offered by this job

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

Job summary

ISTA Solutions is seeking an experienced Healthcare Customer Service Representative to join our growing team in Mandaluyong. You will review ambulance insurance claims, communicate with clients, and ensure accurate adjudication with HIPAA-compliant practices.

The role requires healthcare experience, strong English communication, attention to detail, and the ability to work onsite during night shifts in Mandaluyong. Medical codes knowledge is essential.

Qualifications

• 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.

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 escalation 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.

Job description

ISTA Solutions is seeking an experienced Healthcare Customer Service Representative to join our growing team in Mandaluyong. You will review ambulance insurance claims, communicate with clients, and ensure accurate adjudication with HIPAA-compliant practices.

The role requires healthcare experience, strong English communication, attention to detail, and the ability to work onsite during night shifts in Mandaluyong. Medical codes knowledge is essential.