Claims Supervisor
4 weeks ago
QUALIFICATIONS
4 year graduate of any course
With experience as Claims Processor (Preferably Supervisory level)
Willing to work in Makati
Can start ASAP
DUTIES AND RESPONSIBILITIES:
1. CLAIMS PROCESSING
Ensures accurate review of claims document like LOA, hospital bills/SOA, concurrent review form, physician's report, original OR for use in processing claims.
2. CLAIMS REVIEW/ EVALUATION/ ADJUDICATION
Reviews/evaluates claims and adjudicates claims to ensure claims are according to benefits plan, coverage and policies and standards
3. CLAIMS APPROVAL
Approves claims according to limits of authority.
4. CUSTOMER SERVICE
Ensures provision of quality customer service
Maintains good relationships with providers by making regular visits and ensuring timely payment of medical bills, in coordination with other departments.
Handles inquiries of clients, members and agents regarding application for claims, including handling complaints.
5. ADMINISTRATIVE RESPONSIBILITIES
Undertakes Administrative Responsibilities to ensures proper filing of claims documentation and booking them
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