Claims Assistant

2 days ago

Ortigas, Philippines MEDICARE PLUS, INC. Full time $30,000 - $50,000 per year

Job Summary:

The Claims Assistant provides administrative support to the claims department by processing, organizing, and managing claim-related documents and data. They assist claims adjusters and other team members in handling insurance claims efficiently and accurately. The Claims Assistant plays a crucial role in ensuring that claims are processed in a timely manner and that all necessary documentation is properly maintained.

Responsibilities:

1) Document Management:

a) Receive, sort, and review incoming claim documents and correspondence.

b) Create and maintain electronic and physical claim files.

c) Organize and index documents for easy retrieval.

d) Ensure all documents are accurately labeled, logged, and stored.

2) Data Entry and Processing:

a) Enter claim information into the database or claims management system.

b) Verify data accuracy and completeness.

c) Update claim status and information as required.

d) Generate standard reports and claims-related documents.

3) Communication and Coordination:

a) Assist in responding to customer inquiries regarding claim status and process.

b) Coordinate with internal teams, external vendors, and clients as needed.

c) Maintain regular communication with claims adjusters and provide necessary support.

d) Assist in scheduling appointments, meetings, and inspections.

4) Claim Support:

a) Review and assess claim documents for completeness and accuracy.

b) Assist in determining initial coverage eligibility.

c) Prepare claim-related correspondence, including acknowledgment letters and denial notifications.

d) Support claims adjusters in the investigation and evaluation of claims.

5) Record Keeping and Compliance:

a) Ensure compliance with regulatory requirements and internal policies.

b) Maintain confidentiality and handle sensitive claim information appropriately.

c) Assist in maintaining accurate records of claim activities, payments, and settlements.

d) Collaborate with the legal department to gather information for legal proceedings, if necessary.

6) Process Improvement:

a) Identify opportunities to streamline claim processes and enhance efficiency.

b) Make suggestions for improvements in workflows and procedures.

c) Participate in departmental meetings and provide input on process enhancements.

d) Contribute to the implementation of new technology or software solutions.

Requirements:

· Graduate of any 4 year course, preferably with a Medical Background

· Previous experience in an administrative or data entry role, preferably in the insurance industry.

· Familiarity with claims processing and insurance terminology is advantageous.

· Proficiency in using computer systems, databases, and MS Office applications.

· Excellent organizational skills and attention to detail.

· Strong written and verbal communication skills.

· Ability to handle multiple tasks simultaneously and prioritize workload.

· Basic understanding of confidentiality and data protection principles.

· Team player with a positive attitude and willingness to learn.

  • Claim Support

    2 days ago

    Ortigas, Philippines Ardent Paralegal and Business Solutions Inc. Full time $40,000 - $60,000 per year

    Job SummaryThe Claims Support Specialist will provide assistance in processing and managing insurance claims. This role does not require advanced qualifications but demands attention to detail, accuracy, and the ability to handle claim-related tasks efficiently. The position is comparable in level to a Medical Records Clerk (MRC) and is vital in ensuring...

  • Healthcare Assistant

    2 days ago

    Ortigas, Philippines Contact Center Corp x Sapient Full time ₱20,000 - ₱30,000 per year

    We're growing and we want YOU to be part of our Healthcare Account in Metro Manila Experience a one-day hiring process and salary offer up to 25K plus monthly commissionsYour Day-to-Day:Manage healthcare-related inquiries, claims, and service requests with accuracy and compassion.Provide information about healthcare services, policies, and procedures.Process...

  • legal assistant

    2 days ago

    Ortigas, Philippines Shinagawa LASIK & Aesthetics Center Corp. Full time ₱800,000 - ₱1,200,000 per year

    JOB QUALIFICATIONS: • Graduate of bachelor's degree level in Legal Management. • With at least 1-2 years' relevant experience. • Units earned from law school or law graduate is a plus. • Work experience relating to SEC Compliance, Expat Processing, Labor Relations, Data Privacy Act are preferred. • Excellent written and verbal...

  • AU Accounts Receivable Officer

    2 days ago

    Ortigas, Philippines TeamStaff, Inc. Full time ₱55,000 - ₱580,000 per year

    Duties & ResponsibilitiesAttending contract handovers with the Management and Operations teamsManage job performance, for example, hours worked v hours claimed on the jobReport weekly on job performanceMaintain an audit file for each contract which will include original contract, all correspondence, changes/deviations, amendments, clarifications,...

  • HR Generalist

    2 days ago

    Ortigas, Philippines iSupport Worldwide Full time ₱720,000 - ₱960,000 per year

    Key ResponsibilitiesServe as the primary contact for employee inquiries related to HR, payroll, and benefits.Manage full-cycle recruitment: sourcing, posting, interviewing, and job offers.Conduct new hire orientation and prepare termination paperwork.Process payroll and manage open enrolment for benefits.Coordinate with government agencies (EEOC, FEHC, EDD,...

  • HMO Representative

    2 days ago

    Ortigas, Philippines InLife Health Care Full time $30,000 - $50,000 per year

    JOB REQUIREMENTS: Graduate of any 4-year college course, medical allied (preferred). Experience in insurance / HMO and value-adding services preferred. Good communication, coordination, and negotiation skills. With BPO experience handling healthcare account is an advantage but not required. Okay for project-based employment. Work...

  • HR Benefits Associate

    2 days ago

    Ortigas, Philippines Integrated Link Corporation Full time ₱216,000 - ₱228,000 per year

    Processes employee benefits such as HMO enrollment, deletion, and availment requests, ensuring timely and accurate execution based on established procedures.Coordinates with HMO providers and other vendors for benefit-related transactions, billing concerns, and service coverage.Monitors the implementation and renewal of HMO-related programs and maintains...

  • Senior Officer, Depositary

    2 days ago

    Ortigas Center, Philippines IQ-EQ Full time $60,000 - $80,000 per year

    To work within the Depositary team, assisting in carrying out asset verification, cash monitoring and compliance oversight for investment funds investing in private equity, real estate, infrastructure, renewable energy, and other asset classes. Day-to-day direct responsibility for assisting the oversight and management of a portfolio of Depositary clients...

  • Medical Management Resolution Specialist

    2 days ago

    Ortigas, Philippines Visaya Knowledge Process Outsourcing Corporation Full time $30,000 - $50,000 per year

    Role: Medical Coders - Medical Management Resolution Specialist About Visaya KPO: Visaya Knowledge Process Outsourcing Corporation is a proudly Filipino organization recognized globally for service excellence, innovation, and a culture of malasakit. We are committed to building long-term partnerships through quality, reliability, and a people-first...

  • Accounting Staff

    2 days ago

    Ortigas, Philippines Infinity Outsourcing Services Full time $30,000 - $50,000 per year

    Duties & Responsibilities: Process daily settlement reports from bank partners and upload in Paypanda Portal. Prepare daily issuance reports for processing of internal fund transfer. Reconcile daily settlement reports against bank statement. Investigate and resolve settlement discrepancies. Check the validity of proof of payment provided by...