Claims Processor
2 months ago
CLAIMS PROCESSOR – 1
(Sta. Ana Balibago Angeles City Pampanga Office)
Work Schedule: Mon-Fri 8:30am-5:30pm
Salary Offer: 16, 000
Responsibilities:
➢ Review and analyze healthcare claims for accuracy, completeness, and adherence to contractual agreements and regulatory guidelines.
➢ Verify member eligibility and benefits coverage for submitted claims.
➢ Evaluate medical documentation to assess the appropriateness of services rendered and coding accuracy.
➢ Adjudicate claims accurately and efficiently within established turnaround times.
➢ Identify and investigate potential fraudulent or abusive billing practices.
➢ Communicate claim decisions, payment details, and denials to providers and members effectively.
➢ Collaborate with other departments, such as Provider Relations and Customer Service, to resolve claim-related issues and inquiries.
➢ Maintain comprehensive and organized claim records, and documentation.
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Claims Processor
2 months ago
Sta Ana Balibago Angeles, Philippines Your Go to Recruiter Full timeCLAIMS PROCESSOR – 1 (Sta. Ana Balibago Angeles City Pampanga Office) Work Schedule: Mon-Fri 8:30am-5:30pm Salary Offer: 16, 000 Responsibilities: ➢ Review and analyze healthcare claims for accuracy, completeness, and adherence to contractual agreements and regulatory guidelines. ➢ Verify member eligibility and benefits coverage for submitted...
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Claims Processor
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Angeles, Philippines Your Go to Recruiter Full timeCLAIMS PROCESSOR – 1(Sta. Ana Balibago Angeles City Pampanga Office)Work Schedule: Mon-Fri 8:30am-5:30pmSalary Offer: 16, 000Responsibilities: ➢ Review and analyze healthcare claims for accuracy, completeness, and adherence to contractual agreements and regulatory guidelines. ➢ Verify member eligibility and benefits coverage for submitted claims. ➢...
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Claims Processor
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Angeles, Philippines SOURCETECH SOLUTIONS INC. Full timeEssential Duties and Responsibilities: •Review and analyze healthcare claims for accuracy, completeness, and adherence to contractual agreements and regulatory guidelines.•Verify member eligibility and benefits coverage for submitted claims.•Evaluate medical documentation to assess the appropriateness of services rendered and coding...
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Claims Processor
6 months ago
Angeles City, Philippines SOURCETECH SOLUTIONS INC. Full timeEssential Duties and Responsibilities: • Review and analyze healthcare claims for accuracy, completeness, and adherence to contractual agreements and regulatory guidelines. • Verify member eligibility and benefits coverage for submitted claims. • Evaluate medical documentation to assess the appropriateness of services rendered and coding...
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Claims Processor
6 months ago
Angeles City, Philippines SOURCETECH SOLUTIONS INC. Full timeEssential Duties and Responsibilities: • Review and analyze healthcare claims for accuracy, completeness, and adherence to contractual agreements and regulatory guidelines. • Verify member eligibility and benefits coverage for submitted claims. • Evaluate medical documentation to assess the appropriateness of services rendered and coding...