Fraud and Claims Representative

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. 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...

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....

Opportunity Expired JPMorgan Chase & Co. is hiring for the role of Customer Service Specialist. The Customer Service Specialist is responsible for providing outstanding service to our customers by providing timely resolutions to their queries. They will correspond with our customers through inbound/outbound calls regarding transactions on their accounts such...

Responsible for supporting both the claims and underwriting functions. This role involves coordinating the processing of insurance claims and assisting senior underwriters in evaluating new and renewal applications. The ideal candidate will possess strong organizational skills, attention to detail, and the ability to work effectively in a dynamic...

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...

Technical Support Representative II page is loaded Technical Support Representative II Apply locations Manila time type Full time posted on Posted 3 Days Ago job requisition id R79481 This position is under the LexisNexis Risk Solutions Operations. LexisNexis Risk Solutions is a leader in providing essential information that helps customers across all...

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...

DescriptionWe are looking for a dedicated and supportive Supervisor to coach and motivate our team. The supervisor will be responsible for hiring and training call center representatives, ensuring they are well prepared for their roles. This role requires strong analytical skills and the ability to act as a resource. ResponsibilitiesOrganize, direct, and...

DescriptionWe are looking for a dedicated and supportive Supervisor to coach and motivate our team. The supervisor will be responsible for hiring and training call center representatives, ensuring they are well prepared for their roles. This role requires strong analytical skills and the ability to act as a resource. ResponsibilitiesOrganize, direct, and...

Responsible for soliciting and handling of business of assigned accounts for the company by establishing business relationship with producers/clients.Assists in designing comprehensive insurance packages needed by potential clients Develops and maintains personalized service to clients, brokers and agents through frequent communication and visitations...

Accounts Receivable/Credit Control (Accounting) With over 9,000 professionals across 11 delivery centers in the Philippines, MicroSourcing remains the country's largest offshoring solutions provider.Revenue Cycle Manager, be 100% YOU with MicroSourcingA Revenue Cycle Manager is expected to:Manager is responsible for managing the Insurance Accounts...

Account & Relationship Management (Sales) Candidate must possess at least a Bachelor's/College DegreePreferably 1-4 Yrs Experienced Employees specializing in Sales/Business Development or equivalent.Experience in IT, ICT and/or AV Sales is an advantage but not required.DUTIES & RESPONSIBITIES:Conducts sales calls and/or sales visits to client to strengthen...