Medical Claims Adjudication Professional

A Claims Adjudicator is responsible for reviewing and evaluating insurance claims to determine their validity and the extent of coverage based on policy terms. This role involves analyzing medical records, verifying information, applying policy guidelines, and approving or denying claims accurately while ensuring compliance with regulatory standards.

About the RoleWe are seeking a highly skilled Medical Claims Specialist to join our team at Amaphil (Advanced Medical Access Philippines Inc.). As a key member of our organization, you will play a vital role in processing medical claims and ensuring that all transactions are completed efficiently and accurately.The successful candidate will be responsible...

At Dempsy Resource Management Inc., we are seeking a skilled Medical Claims Examiner to join our team. As a Medical Claims Examiner, you will be responsible for evaluating claims received by checking the completeness of documents, necessity and reasonableness of expenses.We are looking for a detail-oriented individual with excellent analytical skills to...

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...

About the RoleWe are seeking a highly skilled Medical Officer to join our team at Amaphil (Advanced Medical Access Philippines Inc.). As a key member of our organization, you will play a vital role in providing excellent medical services to our clients.The successful candidate will be responsible for managing patient care, processing medical claims, and...

We are seeking an experienced Medical Claims Examiner to join our team at JOB MATCHMAKER. As a Medical Claims Examiner, you will play a crucial role in ensuring that all medical claims are processed accurately and efficiently.Your key responsibilities will include:Evaluating claims to determine their validity and accuracy;Verifying the completeness of claim...

Job Summary:At Dempsy Resource Management Inc., we are seeking a highly skilled Medical Claims Analyst to join our team. As a Claims Validation Specialist, you will play a crucial role in ensuring the accuracy and completeness of medical claims.About the Role:Evaluate claims received by assessing the completeness of documents, the necessity and...

About PenbrothersWe strive to be a leading HR & remote talent management partner, offering talented Filipinos global opportunities in high-growth startups and dynamic companies from the comfort of their own homes.About the ClientOur client is a venture-backed startup that aims to establish a new standard of affordable, preventative care beyond traditional...

Job SummaryWe are seeking a highly skilled Medical Care Coordinator to join our team at Marine Benefits, Inc. in Makati, Philippines.About the RoleProvide exceptional customer service to clients and members globally, ensuring timely resolution of queries and concerns.Closely coordinate with healthcare providers for claims evaluation and case management,...

Job Qualifications:• Must have an experience in processing life insurance claims, adjudicating health or life claims for 2 years and up.• Must be a bachelors degree holder of Finance, Administration or any related• Familiarity with basic regulations governing the insurance industry, including data privacy, anti-bribery and corruption laws.• Strong...

PRIMARY FUNCTIONS:1. Provides AMAPHIL members with a holistically positive and pleasant medical availment experience in the accredited providers.2. Addresses members' concerns regarding their AMAPHIL coverage benefits.3. Monitors daily patient's progress chart to know patient's needs.4. Issues benefit reference, LOAs to the accredited providers every time...

Trinity Workforce Solutions, Inc. seeks a highly skilled Health Claims Officer to join our team in Makati. As a Health Claims Officer, you will be assigned to various hospitals across the country and provide support services to health clients in Metro Manila, Metro Cebu & Davao areas.About the RoleThe role of a Health Claims Officer is centered on customer...

Job Summary:Hunter's Hub Inc. is seeking a highly skilled Insurance Claim Examiner to join our team. As an Insurance Claim Examiner, you will be responsible for assisting the claims officers in drafting settlement and decision letters.Duties and Responsibilities:Assist claims officers in drafting settlement and decision letters.Perform CHUB encoding...

As the Health Claims LO you will be assigned to different hospitals across the county and provide a range of support services to our health clients across Metro Manila, Metro Cebu & Davao areas. The role centers on customer/client management to achieve integrated care outcomes for hospitalized clients.Responsibilities:Assessment / adjudication of "real-time"...

Job SummaryWe are seeking an experienced Medical Biller to join our team as a Medical Claims Specialist. In this role, you will be responsible for managing and resolving medical claims, collaborating with the supervisory team to improve processes, and communicating effectively with patients and insurance carriers.Responsibilities:Manage and resolve medical...

Hybrid - Makati 1-3 Yrs Exp Bachelor Full-timeJob DescriptionEmployee Recognition and RewardsGovernment Mandated BenefitsInsurance Health & WellnessHMOOthersCompany Social Events, Profit SharingMaternity & Paternity Leave, Sick Leave, Solo Parent Leave, Special Leave for Women, Vacation LeaveDescriptionProvide 24/7 quality customer service globally for all...

**Job Overview**Sourcefit DR is seeking a detail-oriented Medical Claims Specialist to manage the billing process for our facilities.The successful candidate will be responsible for ensuring accurate coding of patient services, submitting claims to insurance companies, and resolving billing discrepancies.This role requires expertise in substance abuse...

COMPANY NURSE URGENTSalary offer: P27,000-30,000.00Company 1: (1) Calamba Premiere Industrial Park (CPIP) Brgy. Batino, Calamba, Laguna(FEMALE)Schedule: Mon- Friday: 7am-4pmAge: up to 35 y/o Can start ASAPCompany 2: (1) Golden Miles Business Park, Carmona, Cavite (PREF. FEMALE)Schedule: Mon-Thurs: 8am-6pm Friday: 8am-5pmAge: up to 35 y/o Can start...

We're looking for a detail-oriented Medical Claims Associate to join our team. As a key member of our customer service team, you will be responsible for delivering exceptional patient support and providing expertise in medical claims and insurance verification.About Our CultureR1 RCM is a fast-growing team that values innovation, collaboration, and...

COMPANY NURSE URGENT Qualifications: Registered Nurse With BOSH Training CertificateSalary offer: P27,000-30,000.00Company 1: (1) Calamba Premiere Industrial Park (CPIP) Brgy. Batino, Calamba, Laguna(FEMALE)Schedule: Mon- Friday: 7am-4pmAge: up to 35 y/o Can start ASAPLocation: Calamba, LagunaSchedule: Mon- Friday: 8am-5pmAge: up to 35 y/o Can start...