Medical Claims Examiner
6 days ago
As a Healthcare Claims Representative at UnitedHealth Group, you will be part of a global organization that delivers care through technology to enhance health outcomes.
Your key responsibilities will include providing expert claims support by reviewing, researching, investigating, negotiating, and resolving claims for health plans and commercial customers.
Key Performance Indicators:
- Resolve claims efficiently and effectively while ensuring compliance with policies and regulations.
- Analyze and identify trends in claims data to inform business decisions.
- Collaborate with stakeholders to negotiate claim resolutions.
Required Skills:
- High school diploma or equivalent, or 10+ years of equivalent working experience.
- 4+ years of experience in claims recovery and resolution.
- Moderate proficiency with computer applications, including the ability to learn new complex systems.
- Strong communication and negotiation skills.
We strive to create a culture guided by diversity and inclusion, where everyone feels valued and supported. Our mission is to make healthcare more accessible and equitable for everyone.
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Medical Claims Examiner
7 days ago
Makati City, National Capital Region, Philippines Allianz Popular SL. Full timeJob DescriptionThe role of Claims Officer at Allianz Popular SL involves processing medical claims for clients in their assigned region. We ensure a high level of client service while processing claims within an industry leading 48 hours.The position requires the ability to examine and process claims accurately and efficiently, ensuring compliance with...
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Insurance Claims Examiner
4 days ago
Makati City, National Capital Region, Philippines Trinity Workforce Solutions Full timeTrinity Workforce Solutions is seeking a highly skilled Insurance Claims Examiner to join our team. In this role, you will be responsible for reviewing and evaluating insurance claims to determine their validity and the extent of coverage based on policy terms.The successful candidate will have excellent analytical skills and be able to analyze medical...
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Medical Claims Examiner
5 days ago
Makati City, National Capital Region, Philippines Dempsy Resource Management Inc. Full timeAbout UsDempsy Resource Management Inc. is a leading provider of resource management solutions.Job OverviewWe are seeking an experienced Claims Processor to join our team. As a Claims Processor, you will be responsible for evaluating claims received by checking the completeness of documents, necessity and reasonableness of expenses, and encoding and...
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Claims Processing Specialist
7 days ago
Makati City, National Capital Region, Philippines Allianz Popular SL. Full timeJob OverviewThe Claims Officer is responsible for processing medical claims for clients in their assigned region. This involves examining and processing claims accurately and efficiently, ensuring compliance with company policies and procedures.The ideal candidate will have strong analytical and problem-solving skills, as well as excellent communication and...
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Medical Claims Examiner
1 week ago
Makati City, National Capital Region, Philippines AIA Hong Kong and Macau Full timeKey ResponsibilitiesOur Reimbursement Manager will be responsible for:Monitoring and checking the performance of reimbursementsEvaluating medical cases properlyMonitoring the performance of the Reimbursement section and ensuring SLAs are being metAssisting in dealing with doctors' concerns regarding professional feesCoordinating with the Reimbursement...
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Medical Claims Analyst
4 days ago
Makati City, National Capital Region, Philippines ActiveOne Health Full timeJob Summary:ActiveOne Health seeks a highly skilled Medical Claims Analyst to join our team. In this role, you will be responsible for analyzing medical information, processing claims, and communicating with stakeholders.Key Responsibilities:Analyze medical information to determine claim validityProcess claims in a timely and accurate mannerCommunicate with...
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Claims Examiner Associate
18 hours ago
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Medical Claims Professional
3 days ago
Makati City, National Capital Region, Philippines Hunter's Hub Inc. Full timeJob OverviewHunter's Hub Inc. is a leading provider of health insurance solutions, and we are currently looking for a Medical Claims Professional to join our team.Responsibilities:Adjudicate hospitalization claims in a timely manner.Analyze medical documentation to make informed decisions.Ensure seamless coordination between patients and providers.Key...
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Medical Claims Examiner
5 days ago
Makati City, National Capital Region, Philippines JOB MATCHMAKER Full timeOur TeamWe are a dynamic and growing company that values innovation and excellence in everything we do.Job RequirementsTo be successful in this role, you will need:QualificationsGraduate of Bachelor's degree (preferably medical course)24-30 years oldComputer literate (knowledgeable in Microsoft Office)You will also have relevant work experience in a similar...
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Claims Officer
7 days ago
Makati City, National Capital Region, Philippines Allianz Popular SL. Full timeBENEFITSPerformance Incentive Plan / Yearly BonusRetirement Program and Group Life InsuranceHybrid Work Set-up after 6 months of employmentBe part of a pioneer teamJOB DETAILS / ROLE PURPOSEThe role of Claims Officer involves processing medical claims for clients in their assigned region. We ensure a high level of client service while processing claims...
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Claims Examiner
21 hours ago
Mandaluyong City, National Capital Region, Philippines Chubb Full timeChubb Mandaluyong, National Capital Region, PhilippinesThe primary purpose of this role is to produce a high quality Claims work through prompt and professional contact with customers and brokers. Manage and assess high frequency, simple/ low value claims through effective investigation, reserving and adjustment of claims incurred by insureds across Asia...
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Insurance Claims Examiner
4 days ago
Makati City, National Capital Region, Philippines Pioneer Your Insurance Full timeAt Pioneer Your Insurance, we're looking for a talented Claims Processor to join our team.About the RoleThis is a dynamic opportunity for a highly organized and detail-oriented individual to play a crucial role in processing and reviewing claims.We require you to have strong communication and people skills, as you will be working closely with clients and...
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Insurance Claims Examiner
4 days ago
Makati City, National Capital Region, Philippines Pioneer Your Insurance Full timeJob DescriptionMaintain effective collaboration, coordination, and rapport with clients, stakeholders, and other parties involved in the claims process.A strong foundation in business or finance-related fields is required for this role.Familiarity with claims processing and/or administrative tasks is an asset, but fresh graduates are also encouraged to...
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Claims Administration Expert
18 hours ago
Mandaluyong City, National Capital Region, Philippines Chubb Full time**Senior Claims Examiner Position:**We are seeking a highly skilled Claims Administration Expert to join our team at Chubb. In this senior role, you will be responsible for leading and managing the claims examination process, ensuring that claims are settled promptly and professionally, while maintaining a positive relationship with customers, brokers, and...
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Claims Professional
5 days ago
Makati City, National Capital Region, Philippines JOB MATCHMAKER Full timeAbout UsJOB MATCHMAKER is a leading provider of innovative solutions in the field of medical claims processing.Job DescriptionWe are seeking a highly skilled Claims Processor to join our team. In this role, you will be responsible for evaluating claims by checking the completeness of documents, necessity and reasonableness of...
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Claims Specialist
4 days ago
Makati City, National Capital Region, Philippines Trinity Insurance and Reinsurance Brokers, Inc Full timeCOMPANY PROFILE:Trinity is a full-line insurance broker that provides products and services in both General Insurance and Employee Benefits. For more than three decades, Trinity has transformed the lives of its clients and customers, redefining what it means to be in the business of insurance by creating products and services that are customized,...
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Medical Claims Specialist
2 days ago
Quezon City, National Capital Region, Philippines Sourcefit DR Full timeAbout the Role:The Medical Claims Specialist will play a vital role in our financial team with the primary responsibility of handling all aspects of claims management. This involves reviewing and analyzing the status of claims, navigating various online portals, and regularly communicating with payers.Key Responsibilities:Navigate Different Online Portals:...
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Medical Claims Coordinator
4 days ago
Makati City, National Capital Region, Philippines Trinity Insurance and Reinsurance Brokers, Inc Full timeAbout Us:We are Trinity Insurance and Reinsurance Brokers, Inc., a trusted provider of insurance solutions in the Philippines. Our company offers a wide range of products and services in General Insurance and Employee Benefits.The Role:We are looking for a qualified Claims Specialist to join our team in handling claims related to Employee Benefits. As a key...
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Claims Processor
4 days ago
Makati City, National Capital Region, Philippines ActiveOne Health Full timeJob DescriptionJob Objective / PurposeClaim Processors are responsible for timely processing of medical claims based on the member's health benefit program. They analyze medical information, perform data entry, handle reimbursement claims, and decide whether a claim should be covered or denied. They communicate issues or exceptions to other concerned...
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Claims Processor
3 weeks ago
Makati City, National Capital Region, Philippines JOB MATCHMAKER Full timeSalary Offer: Php 18,000.00Work Schedule: Mon-Fri 8:30am-5:30pm Qualifications: Graduate of Bachelors of Science (preferably medical course) 24-30 years old Computer literate (Knowledgeable in Microsoft Office) Relevant work experience is a plusJob description:Evaluates claims receive by checking the completeness of documents, necessity and reasonableness of...