Claims Processor for Makati and Cebu
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Responsibilities
Provider Network Claims Processing
- Check availability and accuracy of claims details in MAS
- Make necessary corrections of claims details
- Verify unlisted claims in MAS with biller
- Process claims using the prescribed process and based on existing guidelines
- Prepare transmittal for check preparation
- Approve payment for claims within authority limit of Php5,000
- Recommend approval of claims payment beyond authority limit
- Prepare and submit claims statement & SOA to biller for bill back of excess of benefits to client or company
- Turn over complete claims documents to Front Desk for proper filin
Customer Service
- Answer inquiries via email or phone regarding status of claims or overdue payments
- Documentation of medical claims disputes or complaints
- Resolution or escalation of claims disputes or complaints
- Coordination with sales and other work units regarding non-claims related customer concerns received via email or phone
Requirements
- At least 1 year(s) of working experience in the related field is required for this position.
- Candidate must possess at least a Bachelor's/College Degree on any course.
- Preferably Fresh / Entry Level specializing in Healthcare - Nurse/Medical Support and Assistant or equivalent.
- Required skill(s): General Insurance Principles, Product Knowledge, Use of Office Technology, Medical Terminology, Medical Claims and Guidelines Procedures, Analytical Thinking, Attention to Detail, Communication, Interpersonal Skills, Customer Service Skills.
- Required language(s): English, Filipino.
Additional Information
- Location: Makati City, NCR.
- Full Time position(s) are available.
- Number of vacancies: 2.
