Claims Specialist

23 hours ago


Pasig, National Capital Region, Philippines beBeeClaims Full time ₱400,000 - ₱700,000
Job Title: Claims Specialist

The Claims Specialist plays a crucial role in the healthcare claims process. This position ensures that every request is accurate, complete, and optimized for downstream success.

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  • Claims Processing & Quality Assurance: Review incoming claims submissions, correcting incomplete or inaccurate information. Prepare accurate base forms before generating submission packets. Conduct comprehensive quality assurance checks on each claim packet, verifying inclusion of all required details.
  • Claims Investigation: Identify and investigate discrepancies in claims data, resolving issues with missing or unclear information. Collaborate with stakeholders to resolve complex claims-related issues.
  • Claims Resolution: Analyze and resolve claims disputes, ensuring fair and timely resolution for clients. Develop and implement effective claims resolution strategies.
  • Claims Management: Oversee the entire claims process, ensuring efficient and cost-effective resolution. Implement process improvements to enhance overall claims performance.

This role requires exceptional analytical skills, strong communication skills, and a proactive problem-solving mindset.


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