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Provider Payment Resolution Specialist

1 week ago

Manila, National Capital Region, Philippines TakeCare Asia Philippines, Inc. Full time
About the Role

We are looking for a detail-oriented Provider Payment Resolution Specialist to join our team at TakeCare Asia Philippines, Inc. The successful candidate will be responsible for resolving provider payments and ensuring that our members receive the support they need.

Key Responsibilities:
  1. Coordinates and works with the respective claim processor/examiner on any provider reconciliation and ensures these reconciliations are completed and presented to the provider for resolution.
  2. Ensures any outstanding claims based on the outcome of the reconciliation are processed and paid to the provider based on performance goals and expectations.
  3. Meets performance goals and objectives as defined by Management on COB, recoveries, provider appeals and reconciliation.
  4. Provides regular reports to management on performance goals and expectations.
  5. Processes any provider and/or member claims that may be assigned.
  6. Performs other duties as may be assigned.