Medical Claims Associate

Work Set-Up: ONSITE
Work Schedule: Nightshift schedule
Work Location: Onsite – Alabang Corporate Center
Salary: Php: 30,000 + 15% Night Diff + HMO Day 1 and 1 free dependent

Qualifications
- Bachelor’s Degree in any field.
- At least 2 years of experience in a Healthcare BPO environment.
- Proven experience handling inbound calls within a healthcare account.
- Familiarity with medical claims, eligibility verification, and denial management processes.
- Strong command of medical terminology.
- Excellent verbal and written communication skills.
- Strong interpersonal and customer service skills.
- Ability to work independently with minimal supervision.
- High level of accuracy, attention to detail, and organizational skills.
- Proficient in Microsoft Office and other computer application systems.

Job Summary
* We are looking for experienced and detail-oriented Medical Claims Associates to join our growing contact center team in Alabang.
* The ideal candidates will have a strong background in healthcare BPO operations, particularly in handling inbound calls related to medical claims, eligibility verification, and claim status updates.
* You will serve as a key liaison between patients, providers, and insurance companies, ensuring accurate, efficient, and customer-focused service delivery.

Key Responsibilities
- Handle inbound calls from patients, providers, and insurance representatives regarding medical claims, eligibility, and benefits.
- Review, interpret, and explain claim denials and status updates in a clear and professional manner.
- Accurately document all call interactions and actions taken in the system.
- Ensure compliance with HIPAA and other healthcare privacy standards.
- Collaborate with internal teams to resolve claim discrepancies or process issues.
- Maintain a high level of accuracy and attention to detail in all transactions.
- Meet or exceed daily, weekly, and monthly performance targets.
- Continuously update knowledge of medical terminology, insurance policies, and claim processing protocols.