
Senior Executive for Out-of-Network Claims
2 days ago
Job Description:
">We are seeking an experienced Senior Executive for Out-of-Network claims management and resolution. The ideal candidate will have a strong focus on claim follow-up, denial management, and efficient resolution of OON claims, while staying informed on new payers and policies.
">Key Responsibilities:
">- Resolve OON claims post-submission, including denials and underpayments.
- Communicate with insurances, providers, and patients to address OON issues.
- Ensure accurate processing of claims, including eligibility verification and benefit coordination.
- Track and report OON claim status to ensure timely resolution.
- Stay updated on new payers, policies, and industry changes affecting OON claims.
Qualifications:
">- Bachelor's degree or higher in a related field.
- Minimum 2 years of experience in OON claim resolution, with a focus on post-submission issues.
- Strong knowledge of insurance processes, OON billing guidelines, and new payer policies.
- Excellent communication, problem-solving, and organizational skills.
- Proficiency in Excel and ability to learn other software as needed.
Why Work with Us:
">- Competitive salary and monthly bonuses.
- Opportunity for career growth and development.
- Comprehensive training to ensure your success in the role.
- Medical Insurance for self, spouse, and children.
- Increments on successful completion of probation period.
- Bi-annual increments.
- Travel allowance (for female employees).
Work Environment:
">Our office is located in Rawalpindi, Pakistan, and we offer a professional and supportive work environment.
">We encourage you to apply if you possess exceptional communication skills and are ready to take on new challenges.
"][About PMTAC Private Limited:
">PMTAC Private Limited is a leading company in the industry, dedicated to providing excellent services to our clients.
">We are committed to attracting and retaining top talent and offer opportunities for career growth and development.
">If you are passionate about making a difference and are looking for a challenging role, we invite you to apply.
"][-
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