Healthcare Claims Specialist | Get 21K Signing Bonus

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We’re looking for a team player who is ready to contribute to our mission, just like you!

Account Specific Roles and 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 escalate 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.

• 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

What Can We Offer You?

• 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 with us
• We encourage you to follow your passions and learn new skills

Our Commitment To You

• Strong culture and values-driven leadership
• We create opportunities for you to learn and grow at any stage of your career
• Continuous learning and innovation
• We foster an all-inclusive environment where everyone thrives