Claims Specialist

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About Us

Quantanite is a global outsourcing partner delivering exceptional customer experience and back-office solutions to some of the worlds leading brands. We take pride in our fast-paced, inclusive work culture that empowers individuals to perform at their bestwherever they are in the world.

Position Overview

We are seeking a detail-oriented and proactive Claims Specialist to join our team. This role is responsible for reviewing, processing, and following up on insurance claims to ensure timely and accurate reimbursement. You will collaborate closely with internal teams, insurance companies, healthcare providers, and patients to resolve billing discrepancies and maintain compliance with all relevant regulations.

The ideal candidate will have a strong understanding of claims management processes, exceptional organisational skills, and the ability to work effectively in a fast-paced environment.

Key Responsibilities

• Review claims for assigned offices and ensure timely submission.
• Perform quality control checks on patient accounts to verify accurate billing.
• Review and analyse denial queues to identify outstanding claims and unpaid balances.
• Follow up on denied, underpaid, or rejected claims with insurance companies to resolve billing discrepancies and secure correct reimbursement.
• Investigate and resolve claim rejections or denials, including preparing appeals or demands when necessary.
• Collaborate with the Insurance Verification team to confirm eligibility and coverage for patients, ensuring accurate billing information is recorded.
• Communicate with insurance companies, patients, and healthcare providers to obtain additional information needed for claim processing.

Qualifications

• Education: High school diploma or equivalent required; certification in medical billing or coding preferred.
• Experience: Minimum of 2 years in claims processing, medical billing, or a related role.
• Technical: Proficiency in claims management systems and Microsoft Office Suite.
• Knowledge: Solid understanding of insurance claim procedures, denial management, and reimbursement processes.
• Attributes: Strong analytical skills, attention to detail, excellent communication abilities, and the ability to work independently or in a team environment.

What We Offer

• Comprehensive Training: Tools, resources, and ongoing support to ensure your success.
• Career Growth: Opportunities for advancement within a growing international organisation.
• Collaborative Culture: A people-first environment that values diversity, inclusion, and teamwork.
• Global Impact: Be part of a company that partners with leading global brands to deliver exceptional results.

Quantanite is an equal opportunity employer.