Insurance Claim Resolution Specialist

2 days ago


Rawalpindi Cantonment, Pakistan PMTAC Private Limited Full time

Job Summary:

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We are seeking a highly skilled Insurance Claim Resolution Specialist to manage and resolve Out-of-Network claims after initial submission.

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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.

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Key Responsibilities:

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  1. Resolve OON claims post-submission, including denials and underpayments.
  2. Communicate with insurances, providers, and patients to address OON issues.
  3. Ensure accurate processing of claims, including eligibility verification and benefit coordination.
  4. Track and report OON claim status to ensure timely resolution.
  5. Stay updated on new payers, policies, and industry changes affecting OON claims.
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Qualifications:

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  1. Minimum 4 years of experience in OON claim resolution, with a focus on post-submission issues.
  2. Strong knowledge of insurance processes, OON billing guidelines, and new payer policies.
  3. Excellent communication, problem-solving, and organizational skills.
  4. Proficiency in Excel and ability to learn other software as needed.
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Why Join Us:

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  1. Competitive salary and monthly bonuses.
  2. Opportunity for career growth and development.
  3. Comprehensive training to ensure your success in the role.
  4. Medical Insurance for self, spouse, and children.
  5. Increments on successful completion of probation period.
  6. Bi-annual increments.
  7. Travel allowance (for female employees).
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Work Environment:

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Our office is located in Rawalpindi, Pakistan, and we offer a professional and supportive work environment.

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We encourage you to apply if you possess exceptional communication skills and are ready to take on new challenges.

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About PMTAC Private Limited:

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PMTAC Private Limited is a leading company in the industry, dedicated to providing excellent services to our clients.

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We are committed to attracting and retaining top talent and offer opportunities for career growth and development.

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If you are passionate about making a difference and are looking for a challenging role, we invite you to apply.

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