Job Description
Join Virtual Staffing Solutions OPC as a Claims Specialist onsite in Tacloban City, Leyte. This pivotal role supports the accuracy and integrity of claims processing and reimbursement activities across our insurance operations. You will be part of a skilled, onsite team that handles the full lifecycle of claims—from intake and validation to adjudication and payment. Your meticulous attention to detail, adherence to regulatory and company policies, and proactive problem solving will ensure timely reimbursements and high levels of client satisfaction. In this role you will partner with providers, beneficiaries, and internal stakeholders to obtain complete documentation, verify eligibility and benefit terms, and resolve inconsistencies. You will maintain precise data in our claims management system, monitor workload and response times, and contribute to process improvements that reduce cycle times and errors. The position offers a competitive salary and a clear path for professional development in the fields of insurance operations, claims processing, and compliance. We are seeking organized, communicative individuals who are capable of working onsite in a fast paced environment and committed to maintaining confidentiality and compliance with privacy regulations. If you are motivated by accuracy, service excellence, and teamwork, this is a strong fit. As part of our claims team, you will have opportunities to advance into senior claims support, workflow optimization, and analytics. This is a full time onsite position with standard shifts and potential for overtime during peak periods.
Responsibilities
- Review and validate insurance claims for accuracy and completeness to ensure proper reimbursements.
- Enter and update claims data in the claims management system, ensuring data integrity.
- Coordinate with healthcare providers and clients to obtain missing documentation and resolve discrepancies.
- Verify eligibility, coverage, and benefit terms; apply policies and guidelines.
- Identify and escalate claim denials or discrepancies; prepare supporting documentation for reconsideration.
- Maintain compliance with internal controls, privacy regulations, and regulatory requirements.
- Monitor performance metrics, support audits, and contribute to process improvements to reduce cycle times.
Qualifications
- Bachelors degree or relevant experience in insurance, healthcare, or finance.
- 1-3 years of claims processing or insurance support experience preferred.
- Strong attention to detail and data accuracy.
- Proficiency in MS Office and claims management systems; solid data entry and documentation skills.
- Excellent communication skills, both written and verbal, with the ability to work with cross functional teams.
- Knowledge of healthcare billing, coding, and reimbursement processes is a plus.