BPO Healthcare Claims Processor – Day 1 HMO
4 weeks ago
ROLE AND RESPONSIBILITIES Responsible in triaging assigned client claims and make determinations on opening cases for medical record review, in addition, the team also does a thorough review of medical records/documentation and claim history to identify aberrant patterns or trends and exercise independent decision making to determine appropriate follow-up. Once the claim information is organized this will go to the clinical and coding teams for review of medical records. JOB QUALIFICATIONS Graduate of any 4 Year Course With a minimum of 2 years experience in handling Healthcare Claims Processing, Investigations/ Research in a BPO setting or environment Note: Experience in a BPO Healthcare Voice Account Required Must be willing to report onsite in Makati Must have customer service, communication & computer skills WHAT WE OFFER Market Competitive Pay Levels Retirement Plan Medical Plan (HMO) from Day 1 of employment Dental, Medical, and Optical Reimbursements Life and Disability Insurance Paid Time-Off Benefits Sick Leave Conversion Tuition Fee Reimbursement Employee Assistance Program (EAP) Annual Performance Based Merit Increases Employee Recognition Training and Staff Development Employee Referral Program Employee Volunteerism Opportunity All Mandatory Statutory Benefits WHO WE ARE Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare. UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone. We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center. As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world. We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines. Elevate your career with a leading health care company while improving lives. Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together #J-18808-Ljbffr
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Healthcare Claims Representative | Day 1 HMO
4 weeks ago
Makati, Philippines Optum, a UnitedHealth Group Company Full timeROLE AND RESPONSIBILITIES Responsible in triaging assigned client claims and make determinations on opening cases for medical record review, in addition, the team also does a thorough review of medical records/documentation and claim history to identify aberrant patterns or trends and exercise independent decision making to determine appropriate follow-up....
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Provider Dispute Claims Processor
2 weeks ago
Makati City, National Capital Region, Philippines a7e6c6e3-79f5-4249-b203-b473e4e2f293 Full time ₱360,000 - ₱600,000 per yearProvider Dispute Claims Processor | Urgent HiringWork Set-Up: In-Office Training Required | Potential for Remote Work After TrainingLocation: Makati, ValeroExpected Start Date: December 8, 2025Position Summary:We are seeking an experienced Provider Dispute Claims Processor to join our growing healthcare team. This role is responsible for reviewing,...
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Provider Dispute Claims Processor
2 weeks ago
Makati City, National Capital Region, Philippines Imagenet, LLC Full time ₱144,000 - ₱384,000 per yearWork Set-Up: In-Office Training Required | Potential for Remote Work After Training)Location: Makati, ValeroExpected Start Date: December 8, 2025Your next career move starts here – submit your application todayPosition Summary:We are seeking an experienced Provider Dispute Claims Processor to join our growing healthcare team. This role is responsible for...
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Customer Service
2 weeks ago
Makati City, National Capital Region, Philippines NEW ERA PLACEMENT AGENCY CO. Full time ₱240,000 - ₱384,000 per yearReady to take your BPO career to the next level? This is your chance to join a dynamic and rewarding workplaceRole: Customer Care RepresentativeAccount: Healthcare AccountStart Date: October 27, 2025WORK CONDITIONS:Work Location: Bonifacio Global City, Taguig City 1634Work Set-Up: Hybrid (2-3 days onsite)Work Schedule: Fixed Night Shift w/ Fixed Weekends...
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Healthcare Claims Adjudication Lead
2 weeks ago
Makati City, National Capital Region, Philippines Imagenet, LLC Full time ₱1,200,000 - ₱2,400,000 per yearWork Set-Up: In-Office Training Required | Potential for Remote Work After TrainingLocation: Makati, ValeroExpected Start Date: December 8, 2025Position Summary:We are seeking a dynamic and experienced Healthcare Claims Adjudication Lead to oversee our growing healthcare team. This role is pivotal in ensuring timely, accurate, and compliant processing of...
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claims processor
2 weeks ago
Makati City, National Capital Region, Philippines Global Quest Consulting Group, Inc. Full time ₱250,000 - ₱350,000 per yearDate Posted: April 4, 2022Job Location: Makati CityJob Description:Job Description:Checks completeness of required documentsProcess all eligible claims with 5-15 working days TAT depending on pre-agreed credit term with the Provider with the 10-15% margin for error/correctionEnsures that all medical claims for check payment request has secured proper...
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Claims Processor
1 week ago
Makati City, National Capital Region, Philippines Global Quest Consulting Group, Inc. Full time ₱250,000 - ₱500,000 per yearDate Posted: December 23, 2021Job Location: Makati CityJob Description:Job Description:Checks completeness of required documentsProcess all eligible claims with 5-15 working days TAT depending on pre-agreed credit term with the Provider with the 10-15% margin for error/correctionEnsures that all medical claims for check payment request has secured proper...
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Claims Processor
4 weeks ago
Makati, Philippines Paramount Life & General Insurance Corporation Full timeOverview The position is responsible for processing insurance claims accurately and quickly through industry approved claims processing. The job may also entail various claims investigation elements and may involve field work from time to time. Responsibilities Data entry - receives claims documents from clients and books the same to the claims monitoring...
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Health Claims Officer
2 weeks ago
Makati City, National Capital Region, Philippines AXA Full time ₱1,200,000 - ₱2,400,000 per yearEstablished in 1999, AXA Philippines is one of the largest and fastest growing life insurance companies in the country. It offers financial security to more than one million individuals through its group and individual life insurance as well as general insurance products through its subsidiary Charter Ping An.AXA Philippines is one of the first to introduce...
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Health Claims Officer
2 weeks ago
Makati City, National Capital Region, Philippines AXA GROUP Full time ₱900,000 - ₱1,200,000 per yearJob Description:Essentially responsible for carrying out set strategies of Health Claims team relevant to efficient end to end claims processing and provide a delightful customer service. Will supervise and lead the Reimbursement Team in the end-to-end claims processing.Executes strategies and action plans of the department according to goals ( KPI ) for...