Health Claims Officer

5 days ago


Makati City, National Capital Region, Philippines Hunter's Hub Inc. Full time

Hunter's Hub Inc. is seeking a skilled and compassionate Health Claims Officer - Patient Advocate to join our team in providing exceptional support services to our health clients across Metro Manila, Metro Cebu & Davao areas.

About the Role:
  • This role centers on customer/client management to achieve integrated care outcomes for hospitalized clients.
  • You will be responsible for assessing and adjudicating real-time hospitalization claims of insured members, analyzing medical documents, and ensuring proper case management.
  • Your primary goal is to facilitate seamless health customer journeys for hospitalized clients.
Key Responsibilities:
  • Assess and adjudicate hospitalization claims, ensuring timely and accurate processing.
  • Analyze medical documents to determine claim eligibility and coverage.
  • Communicate effectively with customers, agents, and healthcare providers to ensure smooth transactions.
  • Develop and maintain strong relationships with third-party partners, including TPAs and providers.
  • Monitor performance, resolve issues, and escalate as necessary.
  • Provide exceptional customer service, addressing inquiries, concerns, and requests related to health benefits.

Skill Requirements:

  • Excellent communication and interpersonal skills.
  • Strong analytical and problem-solving abilities.
  • Ability to work independently and collaboratively as part of a team.
  • Familiarity with health insurance regulations and industry standards.


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