Administrative Operations Specialist

1 day ago


Quezon City, National Capital Region, Philippines beBeeClaims Full time ₱800,000 - ₱1,200,000
About the Role

Claims Operations Analyst plays a crucial part in ensuring seamless claim processing and management.

This role involves handling claims from intake to resolution, ensuring all regulatory requirements are met, and maintaining accurate records.

Key Responsibilities
  • Manage claims lifecycle, including triage, routing, and assigning tasks to relevant teams.
  • Maintain compliance with company policies, regulatory mandates, and industry standards.
  • Prepare and dispatch claims correspondence, including claim numbers and acknowledgement letters.
  • Document claim files thoroughly, incorporating notes, diaries, and documentation in ImageRight.
  • Update claims information for status changes, party updates, notifications, filings, etc.
  • Review and record medical bills, police reports, contracts, legal bills, and other claim documents.
  • Process and document financial transactions, including claim payments, vendor invoices, attorney expenses, etc.
  • Handle returned checks, voided checks, credits, and other financial transactions.
  • Run reports for fraudulent claim research; report claims to relevant agencies as required.
  • Clear OFAC sanctions on claims indemnity and expense payments.
Requirements and Qualifications
  • Bachelor's degree preferred
  • 5+ years of experience in Commercial / Healthcare Claims
  • Ability to exercise independent judgment and make critical business decisions effectively
Work Environment and Benefits
  • Mid-Senior level position
  • Full-time employment
  • Administrative and Other job function
  • Staffing and Recruiting and Insurance industries


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