Nurse - Medical Benefits

4 weeks ago


Morong, Philippines dnata Travel Group Full time

Overview Job Title: Medical Claims Processor Location: Clark, Pampanga, Philippines Employment type: Full-time Seniority level: Associate Company: dnata Travel Group Responsibilities and Accountabilities Process e-claims received from external medical service providers, including accurate adjudication in accordance with policy terms and conditions. Adhere to the agreed business SOP and service level agreements (SLAs) for claims adjudication. Review and evaluate medical costs and service line items. Review and evaluate medical codes, supporting documents, and observations to determine medical appropriateness. Escalate claims as per the approved SOP. Perform batch reconciliation and closing. Support the team leader with: consolidating claims findings for feedback to EGHQ, claims reporting and utilization trend analysis, adherence to SOP and SLAs, and new joiner/buddy training. Qualifications Filipino citizen or have relevant residence status. Willingness to relocate to Clark, Pampanga. Bachelor’s degree in Nursing or Midwifery. Registered Nurse/Midwife/Dental Nurse. Minimum of 2 years hospital experience as Staff Midwife, Staff Nurse, or Dental Nurse. Job Function and Industry Job function: Analyst and Health Care Provider Industries: Travel Arrangements, Retail Health and Personal Care Products, Airlines and Aviation Additional notes This posting includes standard eligibility information. No longer relevant job-specific alerts or tracking links are included. #J-18808-Ljbffr



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