Health Claims Officer
3 days ago
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 management to achieve integrated care outcomes for hospitalized clients. You will work closely with hospitals, doctors, clinics, and other stakeholders to ensure seamless health customer journeys.
Main Responsibilities- Assess and adjudicate hospitalization claims of insured members in real-time.
- Analyze medical documents related to hospitalization to make accurate claims decisions.
- Approve claim amounts up to P500K and escalate beyond that limit.
- Effectively communicate benefits of health insurance plans to customers and agents both verbally and in writing.
- Conduct case management to ensure a seamless health customer journey for hospitalized clients.
- Facilitate administration of health benefits to all members/policy holders through coordination between patients and providers.
- Develop and maintain strong relationships with third-party providers, TPA, and doctors/hospitals/clinics.
- Monitor performance of AXA LOs and resolve or escalate issues when necessary.
-
Health Claims Officer
4 days ago
Makati City, National Capital Region, Philippines Trinity Workforce Solutions, Inc. Full timeOn-site - Makati 3-5 Yrs Exp Bachelor ContractJob DescriptionDescriptionJob PurposeAs the Health Claims LO you will be assigned to different hospitals across the country 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...
-
Health Claims Officer
3 days ago
Makati City, National Capital Region, Philippines Hunter's Hub Inc. Full timeAs 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"...
-
Health Claims Liason Officer
4 weeks ago
Makati City, National Capital Region, Philippines Eteam Workforce Private Corporation Full timeHealth Claims Liason OfficerOnsiteLocation: Makati CitySchedule: ShiftingContract Duration: 5 monthsSalary Offer: up to Php45,000Job Purpose 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...
-
Health Claims Officer
3 days ago
Makati City, National Capital Region, Philippines Hunter's Hub Inc. Full timeHunter'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...
-
Claims Officer
4 weeks ago
Makati City, National Capital Region, Philippines AXA Full timeBAU Responsibilities:Directly responsible for the adjudication and approval of death, critical illness, TPD, hospitalization benefit of all individual and group insurance claims within his/her approval limit and within the agreed turnaround time.Ensures that the life claims benefits are paid out in accordance with existing Philippine life insurance laws and...
-
Claims Specialist
4 weeks ago
Makati City, National Capital Region, Philippines AXA Full timeResponsibilities:Acknowledge receipt of Claim requests.Upload claim documents to case in the health claims system.Validate claim details in the health claims system.Update Claim status and notes in the health claims system.Update TPA file for endorsement to Claims Control Team.Adhere to service standards of processing administrative requests.Ensure complete...
-
Insurance Claim Examiner
5 days ago
Makati City, National Capital Region, Philippines Hunter's Hub Inc. Full timeJob 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...
-
Claims Coordinator
5 days ago
Makati City, National Capital Region, Philippines Hunter's Hub Inc. Full timeJob 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...
-
Claims Communication Officer
2 weeks ago
Makati City, National Capital Region, Philippines Trinity Workforce Solutions Full timeThe role involves managing claims administration by preparing and sending advisories, updating trackers, monitoring outstanding balances, and performing administrative tasks to ensure efficient claims processing and communication.
-
Health Insurance Benefits Coordinator
3 days ago
Makati City, National Capital Region, Philippines Trinity Workforce Solutions, Inc. Full timeTrinity Workforce Solutions, Inc. is seeking a Health Insurance Benefits Coordinator to join our team in Makati. As a Health Insurance Benefits Coordinator, you will be responsible for facilitating the administration of health benefits to all members/policy holders.About the RoleThe role of a Health Insurance Benefits Coordinator is centered on ensuring that...
-
Life Claims Specialist
5 days ago
Makati City, National Capital Region, Philippines Hunter's Hub Inc. Full timeAbout the Role:Hunter's Hub Inc. is a leading insurance company that requires a dedicated Life Claims Specialist to support our claims process. In this role, you will work closely with claims officers to ensure efficient claim resolution.
-
Claims Monitoring Expert
5 days ago
Mandaluyong City, National Capital Region, Philippines ACTIVEONE HEALTH, INC. Full timeBusiness Operations Analyst - PHIC:We are seeking a highly motivated Business Operations Analyst to support our team in coordinating Philhealth claims. The successful candidate will possess excellent analytical and problem-solving skills and be able to work effectively in a fast-paced environment.Key Areas of ResponsibilityEvaluate PhilHealth claim documents...
-
Financial Claims Coordinator
5 days ago
Mandaluyong City, National Capital Region, Philippines ACTIVEONE HEALTH, INC. Full timeAbout the Role:We are seeking a highly organized Business Operations Analyst to coordinate with our team to ensure seamless execution of Philhealth claims. The ideal candidate will possess strong analytical skills and be able to effectively communicate with stakeholders.Key ResponsibilitiesEvaluate PhilHealth claim documents for completeness and accuracy,...
-
Claims Processing Professional
4 days ago
Makati City, National Capital Region, Philippines Hunter's Hub Inc. Full timeRole Description:The Claims Processing Professional at Hunter's Hub Inc. plays a crucial role in supporting our claims team. This position involves working closely with claims officers to ensure accurate and efficient claim resolution.Main Responsibilities:Collaborate with claims officers to draft settlement and decision letters.Perform CHUB encoding tasks...
-
Medical Claims Adjudication Professional
3 days ago
Makati City, National Capital Region, Philippines Trinity Workforce Solutions, Inc. Full timeWe are looking for a highly skilled Medical Claims Adjudication Professional to join our team at Trinity Workforce Solutions, Inc. in Makati. As a Medical Claims Adjudication Professional, you will play a critical role in ensuring that health insurance claims are processed accurately and efficiently.About the RoleThe Medical Claims Adjudication Professional...
-
Claims Processor
2 weeks ago
Makati City, National Capital Region, Philippines Dempsy Resource Management Inc. Full timeRESPONSIBILITIES:- Evaluates claims receive by checking the completeness of documents, necessity and reasonableness of expenses. - Encoding and simplification of diagnosis-data entry. - Conducts routine reconciliation of Outstanding Accounts with Providers to be reported to Provider Relation Department. - Ensures that all medical claims documents are...
-
Healthcare Claims Processor
5 days ago
Makati City, National Capital Region, Philippines ISTA Solutions Full timeJob DescriptionWe are seeking a highly skilled and experienced Healthcare Claims Processor to join our team. As a member of our team, you will be responsible for managing and processing dental claims from submission to resolution.Key Responsibilities:Manage and process dental claims in a timely and accurate manner.Coordinate with various insurance companies...
-
Claims Processor
5 days 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...
-
Claims Specialist
5 days ago
Makati City, National Capital Region, Philippines ISTA Solutions Full timeJob SummaryWe are seeking an experienced Claims Specialist - Dental Division to join our team. As a member of our team, you will be responsible for managing and processing dental claims, as well as coordinating with insurance companies to verify coverage.Key Responsibilities:Process dental claims from submission to resolution.Verify insurance coverage and...
-
Healthcare Claims Processor
17 hours ago
Makati City, National Capital Region, Philippines ISTA Solutions Full timeJob Summary:We are seeking an experienced and detail-oriented Healthcare Claims Processor to join our team at ISTA Solutions. In this role, you will be responsible for managing dental claims from submission to resolution, ensuring timely and accurate approvals.Key Responsibilities:Manage dental claims from submission to resolution, ensuring timely and...