Medical Claims Resolution Associate

We are looking for an experienced Claims Resolution Manager to join our team at P and I Claims Management Inc.The ideal candidate will have a strong background in insurance claims, excellent analytical skills, and the ability to work well under pressure.Responsibilities include analyzing claims, evaluating evidence, and making recommendations on...

About the RoleWe're looking for a skilled Customer Service Representative for Healthcare Accounts to join our team at ISTA Solutions. As a member of our team, you will have the opportunity to work with highly skilled professionals who prioritize employee satisfaction and work-life balance.In this role, you will be responsible for testing claims for...

About PenbrothersPenbrothers is an HR & remote talent management partner and one of the fastest growing companies in the Philippines. We provide talented Filipinos with 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 with a mission to establish a...

Job Title: Medical Claims Liaison OfficerCompany OverviewHunter's Hub Inc. is a trusted name in the health insurance industry, committed to delivering high-quality service to our members. As a Medical Claims Liaison Officer, you will be responsible for facilitating effective communication between healthcare providers, patients, and our team.Job...

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.

RESPONSIBILITIES:- 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...

BENEFITSPerformance 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...

Salary 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...

Job SummaryThe Claim Reconciliation Processor is a critical role in our operations, responsible for processing account reconciliation requests from accredited Flexicare networks. As a key player in our team, you will ensure that all assigned reconciliations are completed accurately and on time. Your expertise will play an essential part in maintaining the...

We are seeking a highly motivated and detail-oriented Nurse to join our team as a Medical Liaison. In this role, you will be responsible for communicating with clients and companies to ensure that all medical information is up-to-date and accurate.Key Responsibilities:Communicate with clients and companies to ensure that all medical information is up-to-date...

Key ResponsibilitiesMonitor Claim Status: Ensure prompt and accurate payment by tracking the status of medical claims.Resolve Rejections/Denials: Research and implement measures to prevent future occurrences.Document Account Activities: Maintain accurate and up-to-date records of account activities.Collections Management: Post adjustments and manage...

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...

Salary: 25,000 PHP- 45,000/ monthJob Description:Accurate Claims Creation: Ensure the preparation of accurate and compliant medical insurance claims for timely submission.Timely Claim Submission: Oversee the submission of claims to insurance companies, ensuring adherence to deadlines to avoid delays in payments.Claim Denial Management: Address claim denials...

Position Summary:The Medical Billing Specialist - AR will play a vital role in our financial team with the primary responsibility of handling all aspects of claims management, from investigation to resolution. This involves reviewing and analyzing the status of claims, navigating various online portals, and regularly communicating with payers. The position...

We are seeking a highly skilled professional to join our team as a Chargeback Resolution Coordinator. In this role, you will be responsible for actioning guest credit card chargebacks and creating accounts receivable billings to collect unsettled guest onboard expenses, medical expenses; and travel agent commission recalls as per company policy while...

Hybrid - Quezon City 3-5 Yrs Exp Diploma Full-timeJob DescriptionDescriptionMedical Biller & Claims Processor RML-PH - Quezon City (Remote)About UsRML-PH is a dynamic and innovative Health Solutions and Care Delivery Organization committed to transforming the healthcare landscape. With a mission to provide accessible, high-quality healthcare services and...

Pointwest is seeking a Clinical Claims Processor to join our team in the Emergency Room. The ideal candidate will possess a strong understanding of medical coding systems, including CPT, ICD-10, and HCPCS, as well as insurance guidelines.ResponsibilitiesThe Clinical Claims Processor will be responsible for:Preparing and submitting accurate billing data and...

Job Summary:We're seeking an experienced Healthcare Claims Specialist to join our team at ISTA Solutions. As a key member of our team, you will have the opportunity to work with highly skilled professionals who prioritize employee satisfaction and work-life balance. Our company prides itself on creating a culture focused on long-term success and life-long...

Job DescriptionThe Claim Reconciliation Processor is responsible for processing account reconciliation requests from accredited Flexicare networks. This role plays an important part in ensuring that all assigned reconciliations are completed accurately and on time.Duties And ResponsibilitiesReconciles claims records from accredited hospitals and doctors...

About the Role:We are seeking a highly skilled and experienced Sr. Health Claims Analyst to join our team. The successful candidate will be responsible for reviewing and assessing claims, ensuring accurate benefit payouts, and maintaining compliance with policy details, laws, and regulations.Key Responsibilities:Conduct thorough analysis of claims and...