Healthcare Claims Representative | 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 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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BPO Healthcare Claims Processor – 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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Healthcare Claims Adjudication Lead
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Makati, Philippines Emapta Full timeTalk Tech. Drive Sales. Make It Happen. Turn every conversation into an opportunity and every demo into a win. Our client is a groundbreaking AI-driven sales automation company redefining how B2B teams grow. By merging deep prospect research, personalized outreach, and meeting automation into one seamless platform, they've created the world's first truly...
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