Claims Staff

The Claims Team Leader is responsible for overseeing the daily operations of the claims team to ensure the accurate and timely handling of claims and reimbursements. This role demands strong leadership, exceptional attention to detail, and a collaborative mindset to coordinate with various departments including Sales, Finance, and Operations.Key...

JOB BRIEF:The Claims Supervisor will oversee a team of claims adjusters and ensure timely and accurate processing of insurance claims. This role involves supervising daily operations, providing guidance and training, monitoring performance metrics, and ensuring compliance with company policies and regulatory requirements.DUTIES AND RESPONSIBILITIES:Supervise...

Description of the Functions of the DepartmentThe department is responsible for processing the claims and determining whether payment should be made. The department ensures that the following are observed:Checks validity/compensability of claims based on the plan coverage/balance and limits up-to-date membership fee payment (active status) completeness of...

JOB PURPOSE:Responsible for analyzing, adjudicating, auditing and processing of claims (Member's Reimbursement) according to set medical guidelines, policies within the agreed SLAs (Service Level of Agreements).Principal Accountability:Ensures accurate and timely processing of claims from medical service providers within authority limits. This...

Job Objective / PurposeThe Claim Processor is responsible for timely processing of medical claims based on the member's health benefit program. They analyze medical information, perform data entry, handle reimbursement claims, and decide whether a claim should be covered or denied. Communicate issues or exceptions to other concerned departments as...

Job Qualifications:SHS Graduate or Completed at least 2 years of college.Minimum 12 months experience in Healthcare Account Receivable/Collections in a BPO setting.Familiarity with UB Claims and UB04 forms.Experience in medical billing/AR collections.Background in calling insurance (Payer) for claim status and payment disputes.Familiar with EPIC...

Job Qualifications:Completed at least 2 years of college.Minimum 12 months experience in Healthcare Account Receivable/Collections in a BPO setting.Familiarity with UB Claims and UB04 forms.Experience in medical billing/AR collections.Background in calling insurance (Payer) for claim status and payment disputes.Familiar with EPIC SYSTEM.Willing to work...

Project assignment: Metro Manila Subway Project CP-103Job Qualification:Graduate of BS in Civil Engineering preferably Licensed Civil Engineer.With (1) year related work experience in Contract Administration and Management.Proficient in English Language both in oral, reading, and writingAdvantage, but not required; knowledge in global contract documents such...

Discover your 100% YOU with MicroSourcingPosition: Claims SpecialistWork setup & shift: Onsite and Night ShiftSite: 1880 Building, Eastwood Libis, Quezon CityWhy join MicroSourcing?You'll HaveCompetitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life...

ROLE AND RESPONSIBILITIESResponsible in triaging assigned client claims and make determinations on opening cases for medical record review, in addition, the team also does a thorough review of medical records/documentation and claim history to identify aberrant patterns or trends and exercise independent decision making to determine appropriate...