About this role
ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Team Lead (Supervisor-Level, Individual Contributor) 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!
The role focuses on claims processing, payment posting validation, denial management, and billing accuracy within electronic health record (EHR) systems. The ideal candidate must demonstrate strong accountability, critical thinking, and process ownership, despite not managing a team.
Account specific roles and responsibilities:
Claims & Billing Operations
Review and validate medical claims submissions for accuracy and completenessAnalyze approved, pending, and denied claims, ensuring proper follow-up and resolutionRefile or correct claims based on denial reasons (coding issues, eligibility, authorization, etc.)Ensure patient billing accuracy, including adjustments and corrections
Payment Posting & Reconciliation
Audit and validate payment postings in EHR systemsEnsure alignment between EOB/ERA and posted transactionsIdentify discrepancies and escalate or resolve accordingly
Denial Management
Investigate root causes of claim denialsRecommend corrective actions to prevent recurring issuesTrack and manage denial trends and ensure timely resolution
Data Entry & Quality Control
Perform high-volume, accurate data entry and documentationMaintain organized records within client systemsConduct quality checks to ensure compliance with client standards
Client Collaboration
Work directly with the US-based client stakeholdersProvide updates, insights, and recommendations on claims performanceDemonstrate supervisor-level ownership and decision-making
Process Improvement
Identify inefficiencies and suggest process improvementsAct as a subject matter expert (SME) in claims and billing workflowsSupport documentation and standardization of processesRequirements
At least 1-year BPO experience handling a Healthcare Account (Claims and Billing)At least 6 months of team lead / supervisory, QA, or Trainer experienceMust have keen attention to detailsMust know how to use MS Word, Excel, OutlookExcellent verbal and written English skillsWilling to work ONSITE in Shaw Blvd, MandaluyongAmenable working night shiftsBenefits
What Can We Offer You?
Competitive salary and benefitsHealth Insurance with free dependents*10%-night differentialAttendance BonusPaid time offConvertible to cash leave creditsPerformance AppraisalWork-life balanceA focus on growing your career path with usWe encourage you to follow your passions and learn new skills
Our Commitment to You
Strong culture and values-driven leadershipWe create opportunities for you to learn and grow at any stage of your career Continuous learning and innovationWe foster an all-inclusive environment where everyone thrives