Billing Resolution Manager

2 weeks ago


Rawalpindi Cantonment, Pakistan PMTAC Private Limited Full time

PMTAC Private Limited is a dynamic organization seeking an experienced Medical Claims Professional to manage and resolve Out-of-Network claims. The ideal candidate will have a strong focus on claim follow-up, denial management, and efficient resolution of OON claims.

This role involves resolving OON claims post-submission, including denials and underpayments. Effective communication with insurances, providers, and patients is crucial to addressing OON issues. The successful candidate will also ensure accurate processing of claims, track and report OON claim status, and stay updated on new payers and policies.

To excel in this position, the candidate must possess exceptional communication, problem-solving, and organizational skills. A minimum graduation degree and experience in OON claim resolution, with a focus on post-submission issues, are highly valued.

Responsibilities:

  1. Manage and resolve OON claims post-submission.
  2. Communicate effectively with insurances, providers, and patients.
  3. Ensure accurate claim processing, including eligibility verification and benefit coordination.
  4. Monitor and report OON claim status for timely resolution.
  5. Stay informed about new payers, policies, and industry changes affecting OON claims.

Benefits:

  • Out-of-Network bonus.
  • A professional work environment.
  • Opportunities for career advancement.
  • Competitive salary and regular bonuses.
  • Comprehensive training for success in the role.
  • Medical Insurance for self, spouse, and children.
  • Incremental salary increases upon successful completion of probation.
  • Regular performance reviews.


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