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 Insurance
- Strong 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 experience
- Knowledge with Revenue Cycle Management (RCM) is an advantage
- Skilled nursing facility (SNF) admissions or insurance coordination experience is a PLUS
- Proficiency 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, mandaluyong
- Amenable working night shift
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
