Claims Reviewers

Responsibilities:Develop full understanding of each medical and claim payment policy, to ensure accurate diagnosis and procedure code assignment. Understand CMS/regulatory requirements, IBX/AH benefit structure, managed care rules (e.g., HMO Capitation, PPO Network Rules) and other business rules to assure diagnosis and procedure code alignmentReal-time...

About Igloo Igloo (formerly Axinan) is the first full-stack insurtech firm to emerge from Singapore. With offices across Singapore, Indonesia, Thailand, the Philippines, Vietnam, Malaysia, China and India, Igloo is fueled by a mission of making insurance accessible and affordable for all. Igloo's innovation solutions empower companies to eliminate...

About IglooIgloo (formerly Axinan) is the first full-stack insurtech firm to emerge from Singapore. With offices across Singapore, Indonesia, Thailand, the Philippines, Vietnam, Malaysia, China and India, Igloo is fueled by a mission of making insurance accessible and affordable for all. Igloo's innovation solutions empower companies to eliminate operational...

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...

Job SummaryThe Healthcare Accounts Receivable (A/R) Specialist is responsible for the timely and accurate resolution of outstanding insurance account balances through payment collection, adjustment, or write-offs. This role ensures the integrity of billing processes and supports the overall revenue cycle through proactive follow-up and problem...

Responsible for the accurate review/audit of medical claims based defined claims guidelines and policies.Review claims or modifies existing claims according to the appropriate and applicable actionAnalyze claims to determine appropriate action to approve or deny action done by the agentDetermine if accurate payment criteria for clearing pending claims based...

Role DescriptionResponsible for the accurate review/audit of medical claims based defined claims guidelines and policies.Review claims or modifies existing claims according to the appropriate and applicable actionAnalyze claims to determine appropriate action to approve or deny action done by the agentDetermine if accurate payment criteria for clearing...

3 OpeningsTaguigRole descriptionResponsible for the accurate review/audit of medical claims based defined claims guidelines and policies.Review claims or modifies existing claims according to the appropriate and applicable actionAnalyze claims to determine appropriate action to approve or deny action done by the agentDetermine if accurate payment criteria...

Role Description: We are seeking a detail-oriented and analytical Revenue Cycle Denial Representative to join our team. This role is responsible for managing hospital claim denials, identifying root causes, and working with payer's and internal teams to resolve and prevent future denials. The ideal candidate will have experience in hospital revenue cycle...

ResponsibilitiesManage a group of Short-term Disability AnalystsMonitor key performance indicators (KPIs) and conduct performance reviews, and provide coaching to improve agent skills.Manage the stakeholder expectation to support the operations from PGS procedures, and state & federal regulations to make appropriate, accurate, and timely decisions.Monitor...