Health Claims Officer

MAKATI CITY, PH, 9999CLAIMS AND ASSISTANCE250005YEJob DescriptionJob Description: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.Will supervise and lead the Reimbursement Team in the end-to-end claims processing.Executes strategies and...

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 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 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...

Must possess any medical-related field degree;With HMO experience is an advantage but not required;Reviews insurance claims for accuracy and completeness;Verify policy details and coverage;Investigate claims by gathering necessary information from claimants, witnesses, and other relevant parties.;Evaluate claims based on policy provisions and determine the...

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...

This Claims Lead will be responsible for overseeing and managing the daily operations of the claims team. This role involves ensuring efficient processing of claims, maintaining high standards of customer service, and guiding team members to achieve performance targets. The Claim Lead acts as a liaison between the claims team, other departments, and external...

Graduate of any 4-year college course, medical allied (preferred).Experience in insurance / HMO and value-adding services preferred.Good communication, coordination, and negotiation skills.With BPO experience handling healthcare account is an advantage but not required.Okay for project-based employment.Can start ASAPA. JOB PURPOSEThe HMO Coordinator or...

Job Title: Provider Dispute Claims Processor | In-Office Training Required | Potential for Remote Work After TrainingExpected Start Date: September 22Salary: up to Php 35,000Position Summary:We are seeking an experienced Provider Dispute Claims Processor this role is responsible for reviewing, researching, and resolving provider disputes in compliance with...

Job Title: Provider Dispute Claims Processor | In-Office Training Required | Potential for Remote Work After TrainingExpected Start Date: September 22Salary: up to Php 35,000Position Summary:We are seeking an experienced Provider Dispute Claims Processor this role is responsible for reviewing, researching, and resolving provider disputes in compliance with...