Micro HMO Claims Specialist

YOUR ROLE:Contributes to the management of the department's loss ratio by evaluating simple claims cases and handling detected suspicious or fraudulent cases according to the established claims standards and guidelines of the department and Pioneer Group to ensure that claims settlements are fair for both our customers and Pioneer at all times. Contributes...

YOUR ROLE:Contributes to the management of the department's loss ratio by evaluating simple claims cases and handling detected suspicious or fraudulent cases according to the established claims standards and guidelines of the department and Pioneer Group to ensure that claims settlements are fair for both our customers and Pioneer at all times. Contributes...

Job Description:The Claims Non-Voice Specialist is responsible for ensuring the effective and efficient delivery of best customer experience in assisting member OP availment via non-voice request by following the benefit plan and supporting the cost management initiatives which will contribute to client retention.Job Qualifications:Graduate of any...

Job Description:The Claims Non-Voice Specialist is responsible for ensuring the effective and efficient delivery of best customer experience in assisting member OP availment via non-voice request by following the benefit plan and supporting the cost management initiatives which will contribute to client retention.Job Qualifications:Graduate of any Bachelor's...

Job Description:Manage day-to-day healthcare administration tasks, including billing and claims processing. Proactively address urgent cases, ensuring efficiency and compliance with industry standards. Perform assigned duties to optimize overall administration.Essential Duties and Responsibilities: •Liaise with the EASTWEST HEALTHCARE INC. and PILIPINAS...

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...

Commercial Contracting Solutions Consulting is a young and growing company providing specialist commercial advisory, claims management and dispute resolution services to the construction and infrastructure industries. We have a broad client base spanning construction and infrastructure companies across the Australia and Asia. You will be joining a...

We are currently seeking a highly experienced and motivated Claims Manager to join our insurance team in the Philippines. As a Claims Manager, you will be responsible for overseeing the processing and settlement of insurance claims, ensuring that all claims are handled accurately, efficiently, and in accordance with company policies and regulations.Key...

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...

Experienced Medical Billing SpecialistResponsibilities: Examining eligibility and verifying benefits for treatments, hospitalization, and procedures. Examining patient bills for correctness and completeness, as well as gathering any missing data. Utilizing billing software, prepare, evaluate, and send claims, including electronic and paper claim...

Responsible for assuring that microbiological evaluation and related laboratory activities are executed and implemented in accordance with the policies and procedure as defined in Solaire Resort North Laboratory and Solaire Resort North Integrated Food Safety System Executes analytical and technical services based on the company's guidelines and...

Urgently Ortho Billing Specialist Who We Are!Urgently Ortho is a group of orthopedic medical offices based in San Francisco, California. Urgently Ortho offers immediately accessible consultation service for any acute or chronic musculoskeletal injury or pain with an orthopedic specialist. We offer full X-Ray diagnostics and evaluation and will offer...

ROLE AND RESPONSIBILITIESThe role is responsible to provide claims expertise support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities. JOB QUALIFICATIONS Graduate of any 4 Year CourseWith a minimum of 3 years experience in...

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...

The Company Dexcom Corporation (NASDAQ DXCM; Market Cap $44.3B) is a pioneer and global leader in continuous glucose monitoring (CGM). Dexcom began as a small company with a big dream: To forever change how diabetes is managed. To unlock information and insights that drive better health outcomes. Here we are 25 years later, having pioneered an industry. And...

About Us:30+ years of providing care, combined with our health’s innovative tech capabilities, enables us to offer comprehensive, hassle-free digital health plans through our all-in-one platform. Together, we are revolutionizing access to quality, affordable healthcare for millions of Filipinos, one SME at a time.ResponsibilitiesMain point of contact for...

ROLE AND RESPONSIBILITIES:You will respond to customer service inquiries and issues by identifying the topic and type of assistance the customer needs. This may include, among others, inquiries or concerns on their benefits, eligibility and claims.You will guide and educate the customer about the fundamentals and benefits of consumer- driven health care...

ACE Shared Services, Inc. is looking for a Fleet Management Specialist to provide support in dispatching of vehicles and transporting employees, monitoring of company fleet and benefit vehicles, creating of reports, and other tasks related to fleet management. Duties and Responsibilities:Analyzes and solves problems in relation to Fleet...

Senior Java Fullstack DeveloperMakati City Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose – the relentless pursuit of...

Transform Your Career: Global Payroll Specialist Opportunity Awaits!In the dynamic world of payroll support, envision launching your career to global heights—all from within your home turf. This opportunity isn't just another job; it's your ticket to a worldwide stage where you can excel. As a Payroll Administration Specialist in the dynamic payroll...