Team Lead (Individual Contributor) | Healthcare Account | 21K Signing Bonus

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 completeness
• Analyze approved, pending, and denied claims, ensuring proper follow-up and resolution
• Refile 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 systems
• Ensure alignment between EOB/ERA and posted transactions
• Identify discrepancies and escalate or resolve accordingly

Denial Management

• Investigate root causes of claim denials
• Recommend corrective actions to prevent recurring issues
• Track and manage denial trends and ensure timely resolution

Data Entry & Quality Control

• Perform high-volume, accurate data entry and documentation
• Maintain organized records within client systems
• Conduct quality checks to ensure compliance with client standards

Client Collaboration

• Work directly with the US-based client stakeholders
• Provide updates, insights, and recommendations on claims performance
• Demonstrate supervisor-level ownership and decision-making

Process Improvement

• Identify inefficiencies and suggest process improvements
• Act as a subject matter expert (SME) in claims and billing workflows
• Support documentation and standardization of processes

Requirements:
• At least 1-year BPO experience handling a Healthcare Account (Claims and Billing)
• At least 6 months of team lead / supervisory, QA, or Trainer experience
• Must have keen attention to details
• Must know how to use MS Word, Excel, Outlook
• Excellent verbal and written English skills
• Willing to work ONSITE in Shaw Blvd, Mandaluyong
• Amenable working night shifts

Benefits:
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