Claims Analyst

Overview ECLARO Quezon City, National Capital Region, Philippines Claims Operations Analyst Responsibilities Intake, triage, route and assign claims to appropriate resources. Comply with all regulatory requirements, company mandates and policies. Prepare claims correspondence including assigning claim numbers and sending acknowledgement letters. Properly...

This Sr. Claims Analyst position is responsible for the overall review, assessment, and decision of claims.Position Responsibilities:Determine eligible benefits based on documents submitted and policy provisions.Adjudicate claims and determine corresponding recommendation or decision within prescribed approval limits and within the defined turnaround...

YOUR ROLEVerification of cover in order to determine if indeed there is coverage/policy in-force when the loss occursMakes the necessary recommendation on a claim (such as for final action or to require further documents or information) or makes a final decision on claim, in accordance with the claim's authorityHandles the necessary communication that should...

Equicom Services, Inc. is now looking for Medical Claims Analyst who can work onsite.Makati Office: 3F Equicom Center 3308 Zapote St., Brgy. Sta. Cruz, Makati City.QualificationsGraduate of any 4 year medical related courses / Undergrad atleast 3rd year levelOpen for fresh graduatesExcellent oral and written communication skillsAbility to multi-task while...

MAJOR DUTIES AND RESPONSIBILITIES Checks documents received from claimant or intermediary and ensure their correctness. Evaluates each claim assigned and conduct investigation where necessary. Develops plans for investigation of claims and gather all necessary documents and information. Communicates with adjusters, claimants, the insured and other...

REQUIREMENTS: Experience working as a representative of the providers or members line for queries in eligibility and benefits, claims, and authorizations. Preferably with experience in inpatient or outpatient services. Must know the basic insurance terms. Knowledge in Medical Billing/Claims. Experience in Revenue Cycle Management (or a part of)...

JOB PURPOSE:Responsible for analyzing, adjudicating, auditing and processing of claims (Member's Reimbursement) according to set medical guidelines, policies within the agreed SLAs (Service Level of Agreements).Principal Accountability:Ensures accurate and timely processing of claims from medical service providers within authority limits. This...

Overview Role Title: Actuarial Analyst Location: Quezon City, National Capital Region, Philippines Responsibilities Aggregate and stack loss runs from various file types (mostly Excel and PDF). Interpret and analyze large data volumes to identify claims that pierce multiple layers of an insurance tower (e.g., claim that exhausted the SIR limit and affected...

Job Title Bilingual French Accounts Payable Analyst RELX, Quezon City, National Capital Region, Philippines Overview The Accounts Payable Analyst ensures that generally accepted accounting principles, policies and procedures are complied with; internal controls are adhered to; terms of the service level agreement are consistently met; and that efficient...

Overview ECLARO Quezon City, National Capital Region, Philippines Role Title: Reserving Analyst ECLARO: A quick Summary ECLARO is an award-winning professional services firm headquartered in New York City and operating in the U.S., Canada, UK, Ireland, Australia and the Philippines. We are dedicated to a singular purpose: providing the Right People to meet...