Claims Processor

2 months ago


Sta Ana Balibago Angeles, Philippines Your Go to Recruiter Full time

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.


  • Claims Processor

    2 months ago


    Sta Ana Balibago Angeles, Philippines Your Go to Recruiter Full time

    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...

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    Angeles, Philippines Your Go to Recruiter Full time

    CLAIMS 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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    Angeles, Philippines SOURCETECH SOLUTIONS INC. Full time

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    Angeles City, Philippines SOURCETECH SOLUTIONS INC. Full time

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    6 months ago


    Angeles City, Philippines SOURCETECH SOLUTIONS INC. Full time

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