Claims Assistant/Specialist

1 week ago


Pasig Office Hybrid, Philippines Hive Health Full time

Ready to make an impact? At Hive Health and HPPI, a subsidiary of Hive Health, we're on a mission to make healthcare radically more accessible for all—and we need passionate, driven individuals to help us make it happen. If you thrive in a fast-paced, innovative environment and want to work on solutions that truly matter, we'd love to meet you

 Hi We're HPPI, part of the Hive Health GroupAbout us

HPPI is an HMO that is part of the Hive Health Group of Companies, which is on a mission to provide the best-in-class health plans for small-medium enterprises (SMEs) in the Philippines.

HPPI's 30+ years of providing care, combined with Hive Health's innovative tech capabilities, enables the Hive Health Group of Companies to offer comprehensive, hassle-free digital health plans through our all-in-one platform. Together, we are revolutionizing access to quality, affordable healthcare for millions of Filipinos, one SME at a time.

Responsibilities
  • Processing of out-patient and in-patient utilization

    • Checking the completeness of supporting documents

    • Encoding in the Enhanced Membership Monitoring System (EMMS) of details of utilization such as diagnosis, amount, procedure done, hospital bills, and professional fees

  • Processing of members' utilization reimbursement such as maternity assistance, ER changes, laboratory changes, professional fees, dental fees, and death assistance

  • Processing of Account Receivables utilization (for special accommodation of non-members) if applicable

  • Printing of utilization report summary from the EMMS for sending to the Providers (hospitals, doctors, clinics, labs)

  • Perform other functions that may be in line with business needs

Qualifications
  • The first month of employment will be fully onsite, transitioning to hybrid work afterwards

  • Education:

    • Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.

  • Experience:

    • Previous experience in healthcare claims processing, preferably in a startup or tech-driven environment.

    • Familiarity with medical coding and billing procedures.

  • Curious, results-driven, ownership mentality with growth mindset

  • Excellent verbal and written communications

  • Collaborative team player with the ability to adapt quickly in a fast-paced environment

  • Passion for innovation in healthcare

Join our team as we revolutionalize healthcare in the Philippines—and beyond

Day 1 benefits for full-time employees – because we practice what we preach Enjoy comprehensive healthcare coverage for you and your dependent, and paid time off from the start.
Grow with us – mentorship, career development, and learning opportunities to help you thrive.
Global connections – gain insights and support from top minds at Harvard, Stanford, and beyond.



  • Pasig Office - Hybrid, Philippines Hive Health Full time

    Ready to make an impact? At Hive Health and HPPI, a subsidiary of Hive Health, we're on a mission to make healthcare radically more accessible for all—and we need passionate, driven individuals to help us make it happen. If you thrive in a fast-paced, innovative environment and want to work on solutions that truly matter, we'd love to meet youAbout the...

  • Claims Assistant

    2 weeks ago


    Muntinlupa Central Post Office P, Philippines Ifelse Ph Inc. Full time

    QualificationsEducation & TrainingGraduate of any 4-year course, preferably Management, Accounting, etc.Knowledge on basic non-life insuranceBusiness UnderstandingAt least 2 years responsible work experience as Claims Assistant-Motor ClaimsExcellent interpersonal relations and oral and written communication Skills, including platform skillsExperience in...


  • Pasig, National Capital Region, Philippines Tenet Global Business Center, Inc. Full time

    JOB SUMMARYResponsible for the accurate and timely review of complex claims in accordance with applicable contracts, state and federal regulations, health plan requirements, policies and procedures, and generally accepted business practices.ESSENTIAL DUTIES AND RESPONSIBILITIESInclude the following. Others may be assigned.Analyzes professional and hospital...


  • Pasig, National Capital Region, Philippines Connext Full time

    Connext Global Solutionsis a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.We are currently looking for a MedicaClaims Resolution Specialistwho will be working with Connext's...


  • Pasig, National Capital Region, Philippines Fortune General Insurance Corporation Full time

    The Claims Assistant reports to the Claims Officer and Assistant Manager, Non-Motor Claims and is responsible for end-to-end processing of designated Personal Accident (PA) Claims and other related tasks as assigned. This includes validating documents, evaluating Claims, coordinating with the assureds and/or intermediaries, and ensuring timely and accurate...


  • Pasig, National Capital Region, Philippines Fortune General Insurance Corporation Full time

    A.      JOB SUMMARYThe Claims Assistant reports to the Claims Officer and Assistant Manager, Non-Motor Claims and is responsible for end-to-end processing of designated Personal Accident (PA) Claims and other related tasks as assigned. This includes validating documents, evaluating Claims, coordinating with the assureds and/or intermediaries, and...


  • Pasig, National Capital Region, Philippines Fortune General Insurance Corporation Full time

    A. JOB SUMMARYThe Non-Motor Claims Analyst reports to the Claims Officer and Assistant Manager, Non-Motor Claims and is responsible for end-to-end processing of designated Personal Accident (PA) Claims and other related tasks as assigned. This includes validating documents, evaluating Claims, coordinating with the assureds and/or intermediaries, and ensuring...


  • Pasig, National Capital Region, Philippines Risewave Consulting, Inc. Full time

    Job description:The ideal candidate will have a basic understanding of healthcare claims and reimbursement processes, strong communication skills, and the ability to remain composed during challenging interactions. If you're passionate about helping others and thrive in a fast-paced call center environment, we'd love to hear from you.Duties and...


  • Pasig, National Capital Region, Philippines John Clements Consultants, Inc. Full time

    Job PurposeFollow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites.Meets and maintains daily productivity/quality standards established in departmental policies.Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts.Adheres to the policies...


  • Pasig, National Capital Region, Philippines Eastvantage Business Solutions Inc. Full time

    About the Role:The Customer Support Specialist is responsible for delivering high-quality service to customers byresponding to inquiries, resolving issues, and providing product and billing support. This role is criticalin ensuring a positive customer experience through clear communication, problem-solving, and followthrough. The ideal candidate is composed,...