ISTA Solutions , an outsourcing / offshoring company, is in search of an experienced Team Lead 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!
Client specific toles and responsibilities :
Team Lead
- Oversees daily operations for all agents delivering high-quality and valued services
- Conduct training and coaching, including insights and action plans to improve
- Analyze and report on productivity and other metrics - such as attendance, end-of-day reports, and compliance with company protocols
- Ensure that the client is updated on significant program activities, issues, and concerns through calls, emails, meetings, reports
- Perform other supervisory tasks as required
Verification of Benefits
Verify patient insurance eligibility and benefits through payer portals, phone calls, and verification tools.Review and document coverage details including deductibles, copays, coinsurance, out-of-pocket limits, and plan exclusions.Confirm network status, authorization requirements, and benefit limitations based on treatment type or service line.Obtain prior authorizations when required and track authorization status.Communicate benefit summaries and financial responsibilities to admissions, clinical, and billing teams in a clear, timely manner.Maintain accurate documentation in the EHR, practice management system, or verification platform.Identify potential coverage issues that may affect reimbursement and notify appropriate departments.Follow payer-specific guidelines and stay updated with coverage policy changes.Support efforts to reduce denials and improve clean-claim submission rates.Maintain patient confidentiality and adhere to HIPAA and organizational compliance standards.Requirements
With at least 1 year BPO experience handling US Healthcare InsuranceStrong familiarity with U.S. Health Insurance (Medicare, Medicaid, Managed Care, Commercial plans).Understanding of key benefit terminology (deductibles, co-insurance, OOP max, HMO / PPO, SNF benefits, PDPM, etc.).Medical billing, prior authorization, or claims follow-up experienceKnowledge with Revenue Cycle Management (RCM) is an advantageSkilled nursing facility (SNF) admissions or insurance coordination experience is a PLUSProficiency with payer portals such as Availity , NaviNet , and payer-specific platforms.Strong computer literacy and ability to navigate multiple systems simultaneously.Willing to work onsite in Shaw Blvd, mandaluyongAmenable working night shiftBenefits
What can we offer you?
Competitive salary and benefitsHealth Insurance with free dependents10%-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 skillsOur commitment to you
Strong culture and values-driven leadershipWe create opportunities for you to learn and grow at any stage of your careerContinuous learning and innovationWe foster an all inclusive environment where everyone thrives