Health Claims Officer

3 days ago

Makati City, National Capital Region, Philippines AXA Philippines Full time ₱1,200,000 - ₱2,400,000 per year

Description

  1. Essentially responsible for carrying out set strategies of Health Claims team relevant to efficient end to end claims processing and provide a delightful customer service.
  2. Will supervise and lead the Reimbursement Team in the end-to-end claims processing.
  3. Executes strategies and action plans of the department according to goals ( KPI ) for the year
  4. Monitors and ensures prompt resolution on escalated cases including complaints.
  5. Approves escalated cases within the assigned authority limit
  6. Monitors the day-to-day performance of the team, including the daily productivity of the processors through WIP.
  7. Conducts spot audit on claims processed by the team
  8. Provides coaching and mentoring to the team to ensure compliance on the claims processes and policies
  9. Submission of end of day prod report and other report that may be required by the head
  10. Performs other tasks as may be assigned from time to time related to the assigned tasks.

Qualifications

Education: Allied Medical Graduate/ Professional

Experience Required:

Ø
At least 3 years of related work experience ( insurance / HMO) in a supervisor capacity

Ø
With vast experience in customer service

Ø
With exposure to BPO- advantage

Competencies:

Core: Leadership Skills, Customer Centric, Product Knowledge, Claims Processing, Critical Thinking

Technical: Medical Knowledge in Healthcare operations

Universal: Knowledge of MS Office applications

Critical Traits: Good analytical Skills, Good interpersonal skills

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