Medical Claims Manager

4 days ago

Makati City, National Capital Region, Philippines Health Maintenance Inc. Full time ₱900,000 - ₱1,200,000 per year

Qualifications:

  • A graduate of Doctor of Medicine.
  • Had specialty trainings preferably in Surgery, Ob-Gyne, and Pediatrics.
  • Knowledge of complex disease conditions, treatments, tests, and medications.
  • With high attention to details and strong analytical skills.
  • Excellent oral and written communication skills.
  • Ability to multitask while working under minimal supervision.
  • Computer literate with proficiency in MS Office, using MS Word, and MS Excel.

Job Description:

  • Ensures efficient operation of Medical Ancillary and Support Services Division management frameworks (claims processing, reimbursement processing, and underwriting).
  • Manages initiatives in enabling MASSD team to define governance for the strategic processing of the accurate and timely payment of claims.
  • Keeps abreast of any changes in the schedule of payments of providers.
  • In-depth knowledge on the approach of Clinical cases and interpretation of medical information relevant to claims.
  • Deep and solid knowledge of the overall division's functions.

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