Claims Analyst

This Sr. Claims Analyst position is responsible for the overall review, assessment, and decision of claims.Position Responsibilities:Determine eligible benefits based on documents submitted and policy provisions.Adjudicate claims and determine corresponding recommendation or decision within prescribed approval limits and within the defined turnaround...

We are seeking a detail-oriented and analytical Data Analyst – Claims to join our team. The ideal candidate will be responsible for analyzing claims data, identifying trends and anomalies, and providing actionable insights to improve operational efficiency, reduce costs, and enhance customer outcomes. This role bridges data analytics with claims...

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...

Purpose of This Role: Regular account visitation to address customer needs or concerns in prompt and professional manner. Maintaining mutually beneficial business relationship with GPs clients by ensuring accurate and timely processing of claims requests and settlement of valid claims. Meeting needs of customers (internal or external) by addressing or...

The primary role of this position is to support Claims Adjusters located in North America by completing various tasks as instructed. The Claims FNOL Handler will be responsible for a range of activities, including receiving and registering claims, reviewing insurance policies, documenting claims, and coordinating with adjusters, keeping detailed record of...

Role Title:Claims Operations Analyst - Commercial InsuranceECLARO:A quick SummaryECLARO is an award-winning professional services firm headquartered in New York City and operating in the U.S., Canada, UK, Ireland, Australia and the Philippines. We are dedicated to a singular purpose: providing the Right People to meet every client's needs and solve business...

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...

Communicate with policyholders, detect potential fraud, maintained detailed records, ensure timely and compliant claims resolution.Qualifications:Bachelor's degree in business accountancy, IT, or a related field (preferred) or Medical Allied CourseKnowledgeable in MS-Office especially Excel / Data AnalyticsPrior experience in insurance claims processing or...

The A/P Analyst reviews all reimbursements, cash advances (CA), CA liquidations and statutory payments for appropriate documentation and approval prior to payments. He/She is responsible in investigating discrepancies in claims and supporting documents and as per company policies and is responsible to ensure all employee reimbursements and claims are paid...

JOB OVERVIEWWe are seeking a detail-oriented and proactive PhilHealth Claims Processing Assistant to join our healthcare administration team. The successful candidate will be responsible for managing administrative and clerical tasks related to PhilHealth claims processing, ensuring accurate and timely submission of claims, and maintaining compliance with...