Post-Submission Claims Manager

7 days ago


Rawalpindi Cantonment, Pakistan beBee Careers Full time
Claims Resolution Manager

The role involves managing and resolving Out-of-Network claims after their initial submission. Strong claim follow-up, denial management, and efficient resolution of OON claims are essential, alongside staying up-to-date on new payers and policies.

Main Duties:
  1. Resolve OON claims post-submission, addressing denials and underpayments.
  2. Collaborate with insurances, providers, and patients to resolve OON issues.
  3. Evaluate and process claims accurately, verifying patient eligibility and benefits.
  4. Maintain and report OON claim statuses to ensure timely resolution.
  5. Stay informed about new payers, policies, and industry developments affecting OON claims.
Requirements:
  1. Proven experience in OON claim resolution, particularly in post-submission scenarios.
  2. Thorough knowledge of insurance processes, OON billing rules, and new payer regulations.
  3. Superior communication, analytical, and organizational skills.
  4. Proficiency in Microsoft Excel.
What We Offer:
  • Out-of-Network bonus opportunities
  • A professional and supportive work environment.
  • Career advancement opportunities.
  • Competitive salaries and regular performance-based bonuses.


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