Medical Claim Review Specialist

4 days ago

Ayala Alabang, National Capital Region, Philippines beBeeMedicine Full time ₱50,000 - ₱65,000

Medical Claim Review Specialist

About the Role

This role requires a high level of analytical and problem-solving skills, as well as excellent communication and interpersonal skills. As a medical claim review specialist, you will be responsible for reviewing medical claims for medical necessity.

  • Assess and interpret customer needs, requirements, and medical records.
  • Identify solutions to non-standard requests and problems.
  • Solve moderate to complex problems and conduct analysis, work with minimal guidance, translate clinical concepts into practice, and provide explanations and information for difficult issues.
Key Responsibilities

This role owns output at task level and works independently. The successful candidate will be responsible for setting priorities for the team to ensure task completion, coordinating work activities with other supervisors, developing plans to meet short-term objectives, and identifying and resolving operational problems using defined processes, expertise, and judgment.

The ideal candidate will possess strong technical skills, including proficiency in analyzing data and making informed decisions. Additionally, they should have excellent organizational skills, with the ability to prioritize tasks effectively and manage time efficiently.

In this role, you will have the opportunity to make a meaningful impact on our organization's success. You will be part of a dynamic team that values collaboration, innovation, and continuous learning. If you are a motivated and detail-oriented individual who is passionate about delivering exceptional results, we encourage you to apply.

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