medical claims

JOB PURPOSE:Responsible for analyzing, adjudicating, auditing, and processing claims (In-Patient, Out-Patient Hospital Bills and Professional Fees) according to set medical guidelines, and policies within the agreed SLAs (Service Level of Agreements)JOB QUALIFICATIONS:Graduate of Bachelor of Science in Nursing or any related medical course - FRESH GRADUATES...

Date Posted: August 23, 2019Job Location: Makati CityJob Description:check completeness of required documentsensure that all medical for check payment request has secured proper approval.conducts routine reconciliation of outstanding accounts with providers.ensure that all medical claims documents are properly filed and labeled.perform other duties maybe...

Please visit for more information. Acknowledge receipt of Claim requests. Upload claim documents to case in the health claims system Validate claim details in the health claims system Update Claim status and notes in the health claims system Update TPA file for endorsement to Claims Control Team Adheres to service standards of processing...

YOUR ROLEVerification of cover in order to determine if indeed there is coverage/policy in-force when the loss occursMakes the necessary recommendation on a claim (such as for final action or to require further documents or information) or makes a final decision on claim, in accordance with the claim's authorityHandles the necessary communication that should...

Established in 1999, AXA Philippines is one of the largest and fastest growing life insurance companies in the country. It offers financial security to more than one million individuals through its group and individual life insurance as well as general insurance products through its subsidiary Charter Ping An. AXA Philippines is one of the first to introduce...

BAU Responsibilities:Directly responsible for the adjudication and approval of death, critical illness, TPD,  hospitalization benefit of all individual and group insurance claims within his/her approval limit and within the agreed turn around time. Ensures that the life claims benefits are paid out in accordance with existing Philippine life insurance laws...

Date Posted: September 21, 2015Job Location: Makati CityJob Description:.Qualifications:Graduate of any four (4) year business course or equivalentAt least one (1) year experience in HMO claims processing and claims reviewingWith knowledge in ICD 10Must be familiar with medical terms*Only shortlisted candidates will be notified.

Provider Dispute Claims Processor | Urgent HiringWork Set-Up: In-Office Training Required | Potential for Remote Work After TrainingLocation: Makati, ValeroExpected Start Date: December 8, 2025Position Summary:We are seeking an experienced Provider Dispute Claims Processor to join our growing healthcare team. This role is responsible for reviewing,...

Work Set-Up: In-Office Training Required | Potential for Remote Work After Training)Location: Makati, ValeroExpected Start Date: December 8, 2025Your next career move starts here – submit your application todayPosition Summary:We are seeking an experienced Provider Dispute Claims Processor to join our growing healthcare team. This role is responsible for...

Date Posted: December 23, 2021Job Location: Makati CityJob Description:Job Description:Checks completeness of required documentsProcess all eligible claims with 5-15 working days TAT depending on pre-agreed credit term with the Provider with the 10-15% margin for error/correctionEnsures that all medical claims for check payment request has secured proper...