Claims Officer

3 weeks ago


Metro Manila, Philippines Q2 HR Solutions Inc. Full time

Responsibilities

Processing of out-patient and in-patient utilizationChecking the completeness of supporting documentsEncoding in the Enhanced Membership Monitoring System (EMMS) of details of utilization such as diagnosis, amount, procedure done, hospital bills, and professional feesProcessing of members’ utilization reimbursement such as maternity assistance, ER changes, laboratory changes, professional fees, dental fees, and death assistanceProcessing of Account Receivables utilization (for special accommodation of non-members) if applicablePrinting of utilization report summary from the EMMS for sending to the Providers (hospitals, doctors, clinics, labs)

Qualifications

Must be willing to work onsite in OrtigasEducation:Bachelor's degree in Healthcare Administration, Business, or a related field.Experience:Previous experience in healthcare claims processing, preferably in a startup or tech-driven environment.Familiarity with medical coding and billing procedures.Curious, results-driven, ownership mentality with growth mindsetExcellent verbal and written communicationsCollaborative team player with the ability to adapt quickly in a fast-paced environmentPassion for innovation in healthcare

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