Claims Processing Specialist

4 days ago


Mandaluyong City, National Capital Region, Philippines RelianceUnited Full time

**Job Requirements:**

We are looking for a detail-oriented Claims Processing Specialist to join our team at RelianceUnited. As a key member of our healthcare operations, you will be responsible for processing claims reconciliation requests from accredited Flexicare network providers.

**Key Responsibilities:**

  • Process claims records from accredited hospitals and doctors within agreed timeframes to avoid service suspensions.
  • Research variances and collaborate with claims team members, provider relations, and accounting to resolve reconciliation issues.
  • Maintain accurate logs and records used by the Recon team.
  • Provide guidance and support to colleagues on claims reconciliation processes and procedures.

**Ideal Candidate:**

  • Bachelor's degree in any field or equivalent experience.
  • Prior experience in claim reconciliation within the HMO or insurance industry is preferred.
  • Strong analytical and problem-solving skills, with ability to work independently and as part of a team.
  • Excellent communication and critical thinking skills, with proficiency in Google platforms (e.g., GDocs, GSheets) and MS Office.


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