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Medical Insurance Claims Specialist

2 weeks ago

Manila, National Capital Region, Philippines Hunters Hub Inc. Full time
Job Description

Hunters Hub Inc. is seeking a skilled Medical Insurance Claims Specialist to join our team.

About the Role:

  • Assess and adjudicate medical claims for insured members in real-time, ensuring timely and accurate decision-making.
  • Analyze medical documents to determine claim validity and make informed decisions.
  • Communicate effectively with clients and stakeholders to provide seamless customer service.
  • Foster strong relationships with healthcare providers and third-party administrators to ensure smooth operations.
  • Maintain up-to-date knowledge of healthcare policies and regulations to stay compliant.

Key Responsibilities:

  • Review and process hospitalization claims, ensuring compliance with company policies and procedures.
  • Collaborate with internal teams to resolve claim-related issues and improve customer satisfaction.
  • Develop and maintain strong relationships with healthcare providers to ensure efficient claim processing.
  • Stay current with industry developments and updates to ensure Hunters Hub Inc.'s competitive edge.

Requirements:

  • 4-year degree in a related field (e.g., healthcare, business administration).
  • Minimum 5 years of experience in medical claims or a related field.
  • Excellent communication and problem-solving skills.
  • Ability to work in a fast-paced environment and prioritize tasks effectively.