Claims Analyst

2 days ago

Taguig, National Capital Region, Philippines Ascendion Full time

General Description:

This position is responsible for the overall review, assessment, and decision of claims.

Responsibilities:

  • Determine eligible benefits based on documents submitted and policy provisions.
  • Adjudicate claims and determine corresponding recommendation or decision within rescribed approval limits and within the defined turnaround time.
  • Ensure accurate benefit payouts in accordance with the policy details, laws and regulations.
  • Assist junior adjudicators with complex claims beyond their authorities.
  • Escalate possible fraudulent claims to the Team Lead and recommend appropriate action.
  • Actively participate in and contribute to projects and initiatives.

Skill Set

  • Excellent written and oral communication skills
  • Highly analytical
  • Excellent understanding of life insurance policy provisions
  • Understands common medical terms and illnesses
  • With knowledge and understanding of insurance laws and regulations
  • Quick thinker and can work independently under pressure

  • Coordinator - Claims Advisory

    6 days ago

    Taguig, National Capital Region, Philippines Marsh McLennan Full time

    We are seeking a talented individual to join our Operations team at Marsh. This role will be based in Philippines. This is a hybrid role that has a requirement of working at least three days a week in the office.We will count on you to:Handles complex issues pertaining to claims complications and claims processes, escalating where necessary, to ensure...

  • Coordinator - Claims Advisory

    4 days ago

    Taguig, National Capital Region, Philippines Marsh Full time

    We are seeking a talented individual to join our Operations team at Marsh. This role will be based in Philippines. This is a hybrid role that has a requirement of working at least three days a week in the office.We will count on you to:Handles complex issues pertaining to claims complications and claims processes, escalating where necessary, to ensure...

  • Coordinator - Claims Advisory

    2 weeks ago

    Taguig, National Capital Region, Philippines Marsh McLennan Full time

    Company:MarshDescription:We are seeking a talented individual to join our Operations team at Marsh. This role will be based in Philippines. This is a hybrid role that has a requirement of working at least three days a week in the office.We will count on you to:Handles complex issues pertaining to claims complications and claims processes, escalating where...

  • Reconciliation Analyst

    2 weeks ago

    Taguig, National Capital Region, Philippines Prime Manpower Resources Development Inc Full time

    In an insurance company environment, the Reconciliation Analyst works closely with underwriting, billing, claims, finance, and external carriers or partners to investigate discrepancies, resolve variances, and maintain accurate financial records.The Reconciliation Analyst is responsible for reconciling insurance-related financial transactions to ensure...

  • Internship - Claims Data Associate (Travel)

    2 days ago

    Taguig, National Capital Region, Philippines Amadeus Full time

    Job TitleInternship - Claims Data Associate (Travel)Job Title:Internship - Claims Data Associate (Travel)In this role you will:Purpose of this role:The associate claims data analyst intern will support in investigating claims as a result of a financial loss in using Amadeus, ensuring the accuracy of claims processing, and delivering actionable insights to...

  • Internship - Claims Data Associate (Travel)

    2 days ago

    Taguig, National Capital Region, Philippines Amadeus Full time

    Job TitleInternship - Claims Data Associate (Travel)Job Title:Internship - Claims Data Associate (Travel)In this role you will:Purpose of this role:The associate claims data analyst intern will support in investigating claims as a result of a financial loss in using Amadeus, ensuring the accuracy of claims processing, and delivering actionable insights to...

  • Quality Analyst

    2 weeks ago

    Taguig, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

    About the role This is an exciting opportunity to join Access Healthcare Services Manila, Inc. as a Quality Analyst in our dynamic Healthcare BPO team. As a Quality Analyst, you will play a crucial role in ensuring the highest standards of customer service and operational excellence within our AR Claims division. In this full-time position based in Taguig...

  • Quality Analyst

    4 days ago

    Taguig, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time

    About the role Access Healthcare Services Manila, Inc. is seeking a Quality Analyst to join our growing team in Taguig City, Metro Manila. As a Quality Analyst, you will play a crucial role in ensuring the highest standards of customer service and accuracy in our medical claims processing operations. This is a full-time position where you will be...

  • Quality Analyst

    2 weeks ago

    Taguig, National Capital Region, Philippines Access Healthcare Full time

    This is an exciting opportunity to join Access Healthcare Services Manila, Inc. as a Quality Analyst in our dynamic Healthcare BPO team. As a Quality Analyst, you will play a crucial role in ensuring the highest standards of customer service and operational excellence within our AR Claims division. In this full-time position based in Taguig City, Metro...

  • Vendor Debits Bid Loading Analyst

    2 weeks ago

    Taguig, National Capital Region, Philippines TASQ Staffing Solutions Full time

    About the job: Vendor Debits Bid Loading Analyst (McKinley Taguig) | Onsite Work Setup: Full Onsite (McKinley Taguig) Shift: Open to any shift HMO Package: Day 1 Start Date: ASAP Responsibilities:Process Special Pricing RequestSupport sales and the internal department in administering and validating all vendor pass-through special pricing programs.Processing...