Operations Coordinator

1 day ago

Makati City, National Capital Region, Philippines Inova Care Full time

JOB DESCRIPTION

OPERATIONS COORDINATOR

Key Responsibilities

Job Summary:

Oversees and manages daily operations for its clients, affiliate dental and medical facility partners,

and vendors in connection with appointment booking, eligibility, benefit coverage and limitation,

and claims adjudications associated with a wide range of medical and dental insurance products.

Duties/Responsibilities:

Customer Service

· Provide quality customer service telephonically and proper documentation via the platform with regards to appointments, benefits, and claims concerns.

· Properly document and update call and complaint logs as well as generate activity reports routinely.

· Handle inbound and outbound customer service-related calls for members and health care providers.

· Entry of all customer service-related information into the company's CRM tools.

· Processing and management of all provider and member non-voice inquiries (post, email, and fax).

· Transfer of select inquiries to the appropriate person or department as indicated by management.

· Properly document and update call and complaint logs, as well as generate activity reports on a daily, weekly, monthly, quarterly, and annual basis.

· Perform authorizations for simple outpatient, dental, and health care screening benefits based on coverage and member eligibility.

· Coordination of members' health care needs (according to benefit plan) domestically and regionally through the appropriate counterparts.

· Adhere to all policies and procedures that apply to each market.

Provider Recruitment and Relations

· Attend provider recruitment meetings and presentation as required.

· Ensures that provider contacts and supporting documents are submitted in a timely manner.

· Manage provider service projects as needed and ensure that deadlines are met.

· Prepare various reports including regular updates on recruitment and service projects as directed by Management.

Claim Analysis

· Retrieval of claims documents to and from mailing address.

·       Medical claims processing and analysis of all claims.

· Compile, verify, interpret, analyze and summary of claim data and preparation of client payment report.

· Investigating potentially fraudulent claims.

· Review and obtain necessary approval of documents from policyholders and providers.

· Identify and resolve claim related inquiries and issues.

Adaptation of Responsibilities Based on Business Requirements in Cases of Limited Transactions

· In the event of limited or no transactions, the Operations Coordinator may be assigned additional responsibilities to support the team's ongoing needs.

  • Project Coordinator

    2 days ago

    Makati City, National Capital Region, Philippines White & Case Global Operations Center Manila Full time

    Project CoordinatorFulltime | Hybrid | MakatiJob SummaryWe are seeking a detail-oriented and proactive Project Coordinator to support the planning, coordination, and execution of technology projects. Working closely with Project, Program, and Portfolio Managers, you will help ensure projects are delivered successfully and on time. This role also provides the...

  • Operations Coordinator

    2 weeks ago

    Makati City, National Capital Region, Philippines C9 Staff Full time

    OPERATIONS COORDINATOR (MEDIA & PUBLISHING)Job Title: Operations Coordinator (Media & Publishing)Job Category: Full-Time (40 hours per week)Job Location: 100% work-from-homeJob Schedule: Mondays through Fridays, 9:00 AM - 6:00 PM Eastern TimeAbout Us:At C9 Staff, we're passionate about connecting exceptional Filipino professionals with stable, global clients...

  • Retail Operations Coordinator

    2 weeks ago

    Makati City, National Capital Region, Philippines Kimtan Labs Inc. Full time

    Company DescriptionKimtan Labs, headquartered in Singapore, is an FMCG company dedicated to building the next generation of health, wellness, and personal care brands for Southeast Asia. With a focus on culturally resonant products, we thrive across omnichannel ecosystems, spanning e-commerce platforms to premium retail distribution. Our portfolio includes...

  • Sales Operations Coordinator

    2 weeks ago

    Makati City, National Capital Region, Philippines Aether Global Technology Full time

    Job Description: Sales OperationsWork set-up: HybridLocation: PhilippinesAbout Aether GlobalAether Global is a dynamic Salesforce consultancy specializing in Implementation, Managed Services, and Staff Augmentation. We help our clients optimize their operations, and we hold ourselves to the same standard. As we scale, we are looking for a process-driven...

  • Business Operations Coordinator

    5 days ago

    Makati City, National Capital Region, Philippines Cambridge University Press & Assessment | Manila Full time

    Business Operations CoordinatorWork setup: We operate in a hybrid work environment, and we encourage applicants who are open to working in the office two days a week to apply.Work schedule: Monday to Friday, 2:00-10:00 pm Manila timeEmployment type: PermanentLocation: Makati City, Metro ManilaPay range: Php 28,000 to 36,000We value transparency and want to...

  • Operations Coordinator

    2 weeks ago

    Makati City, National Capital Region, Philippines SGS Full time

    Company DescriptionSGS is the world's leading Testing, Inspection and Certification company. We operate a network of over 2,700 laboratories and business facilities across 119 countries, supported by a team of 99,250 dedicated professionals. With over 145 years of service excellence, we combine the precision and accuracy that define Swiss companies to help...

  • Operations Coordinator

    6 days ago

    Quezon City, National Capital Region, Philippines VCP Trading International Corp. Full time

    JOB DESCRIPTIONOperations Coordinator (HR–ISO–Strategy)Location: Office-based Monday to Friday, 8:30 to 5:30 / Hybrid Option available for consultant statusDepartment: Operations / Strategy / QualityReports To: VP HR / Lead Consultant / QMRROLE PURPOSEThe Operations Coordinator is responsible for daily coordination of HR projects, ISO systems, strategic...

  • Operations Coordinator and Claims Administrator

    2 weeks ago

    Makati City, National Capital Region, Philippines Inova Care USA Full time

    Position OverviewWe are seeking a detail-oriented and proactive Operations Coordinator / Claims Administrator to join our team. This role is critical in ensuring seamless execution of claims processing, customer service, and provider relations functions in alignment with company standards. The position requires strong organizational skills, adaptability, and...

  • Operations Coordinator

    2 weeks ago

    Cotabato City, Autonomous Region in Muslim Mindanao, Philippines UpSkill MNL Full time

    Ensure that all operational activities are carried out in a timely and efficient manner.Coordinate day-to-day operations tasks, such as scheduling, logistics, and staff management.Helps assigned teams meet and exceed their goals and objectives.Create and maintain records for all operational activities and ensure that all documents are filed...

  • Operations Coordinator

    2 weeks ago

    Mandaluyong City, National Capital Region, Philippines Stolt-Nielsen Full time

    Description Are you as excited as we are when we talk about the storage and distribution of bulk liquids at our state-of-the-art tank containers and terminals located in key markets? Could this be the scene for your next career move? We are currently recruiting for Operations Coordinator to join our APAC Operations team.Stolt Tank Containers (STC) is a...