Fraud and Claims Representative

In this role, you will:Support and capture all pertinent information from customers about their claimsConduct research and provide updates on status of new and existing claimsIdentify opportunities to improve customer experience after thorough research of complex account activity, and take appropriate actions to handle the claimPerform routine customer...

-Reviews all claims documents and relates it to the insurance policy for compliance-Tasked to inspect the damages sustained by the vehicles being claimed, canvass the necessary parts and make recommendations on the most accurate amount of repair that can be approved for the claims filed.-Tasked to scan and evaluate bodily injury claims filed under the...

As the Head of Claims and Customer Service (CS) for Discover ASO Corp. aka SIMPLeTPA, he/she is primarily responsible to assure claims are managed within the specific plan guidelines and charges for claims services are reasonable and customary. In order to perform this role in an efficient manner, the Head of Claims and Customer services will be integral...

Industrial Relations & Employment Law (Legal) Be the spark that brightens days and ignite your career with TTEC's award-winning employment experience. As a Compliance & Fraud Analyst working remotely in The Philippines, you'll be a part of bringing humanity to business. #experienceTTECOur employees have spoken. Our purpose, team, and company culture are...

The SeaMoney team enables and drives innovation by providing a range of financial products and services, including its mobile wallet, ShopeePay, to both individuals and SMEs. Its mission is to better the lives of individuals and businesses in the region with financial services through technology. SeaMoney is a part of Sea Limited, a leading global consumer...

Apply Today! Don't delay, qualified candidates will be reviewed on a rolling basis. Job Description: Member Services Representative (Healthcare)Position Overview:Join our team as a Member Services Representative (Healthcare), where you will play a crucial role in taking member services calls in relation to policy management, benefits and claim inquiries....

Job Description:Graduate of any business course.Preferably has experience as Trade Admin, but fresh graduates are welcome to apply.Receives all pertinent documents such as but not limited to Claims, PWPs, Promotional letters, memo etc. as representative of Trade Admin.Receives and checks distributor claims together with its attachments.Validate claim’s...

Job Description:Conducts appropriate account activity on final billed claims by contacting government agencies, third party payors, and patients/guarantors via phone, e-mail, or online. Continues collection activity until account is resolved, sent to Legal, ordisputed. Responsible for maintaining inventory on desks with no backlog. Ensure daily productivity...

DutiesPosting of charge payment and downloading ERA/EOBInvestigating and appealing denied claims. Ability to correct denial claims with correct information and resubmit claims.Perform A/R of each insurance.Checking patient benefits and insurance eligibilityQualification:Proven work experience as a medical billerKnowledgeable with US Healthcare...

Liaise for the day-to-day administration of Health Plan, Insurance Coverage and Dental ProgramReport and monitor receipts of additions/deletions, covering endorsements, billing, membership IDs from the Principals, Dependents, and Extended DependentsFile and monitor the status of claims filed for reimbursement by members after pre-adjudication of claims and...

JOB SUMMARYResponsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims. ESSENTIAL DUTIES AND RESPONSIBILITIESValidate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons....

Apply Today Don't delay, qualified candidates will be reviewed on a rolling basis. Job Description: Member Services Representative (Healthcare)Position Overview:Join our team as a Member Services Representative (Healthcare), where you will play a crucial role in taking member services calls in relation to policy management, benefits and claim inquiries. You...

Position Type : Full time Type Of Hire : Experienced (relevant combo of work and education) Education Desired : General Equivalency Diploma Travel Percentage : 0%Are you curious, motivated, and forward-thinking? At FIS you'll have the opportunity to work on some of the most challenging and relevant issues in financial services and technology. Our talented...

Position Type : Full time Type Of Hire : Experienced (relevant combo of work and education) Education Desired : General Equivalency Diploma Travel Percentage : 0%Are you curious, motivated, and forward-thinking? At FIS you'll have the opportunity to work on some of the most challenging and relevant issues in financial services and technology. Our talented...

As a PHRN Insurance Voice Representative, you will be the frontline of our insurance company, providing exceptional customer service and support to our clients. Your primary responsibility will be handling inbound and outbound calls, addressing inquiries, resolving issues, and providing information regarding insurance policies, claims, and related services....

As a PHRN Insurance Voice Representative, you will be the frontline of our insurance company, providing exceptional customer service and support to our clients. Your primary responsibility will be handling inbound and outbound calls, addressing inquiries, resolving issues, and providing information regarding insurance policies, claims, and related services....

As a PHRN Insurance Voice Representative, you will be the frontline of our insurance company, providing exceptional customer service and support to our clients. Your primary responsibility will be handling inbound and outbound calls, addressing inquiries, resolving issues, and providing information regarding insurance policies, claims, and related services....

As a PHRN Insurance Voice Representative, you will be the frontline of our insurance company, providing exceptional customer service and support to our clients. Your primary responsibility will be handling inbound and outbound calls, addressing inquiries, resolving issues, and providing information regarding insurance policies, claims, and related services....

Job Description:Responsible for processing accounts and working with designated payors to ensure proper reimbursement.Responsible for all aspects of follow-up and collections, including making telephone calls, and accessing payer websites. Identify issues or trending and provide suggestions for resolution. Accurately and thoroughly documents the pertinent...

Position Type : Full time Type Of Hire : Experienced (relevant combo of work and education) Education Desired : General Equivalency Diploma Travel Percentage : 0%Are you curious, motivated, and forward-thinking? At FIS you’ll have the opportunity to work on some of the most challenging and relevant issues in financial services and technology. Our...