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.