Health Claims Officer
5 days ago
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.
- 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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