Job Description

Job Objective / Purpose

Claim Processors are 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, decide whether a claim should be covered or denied. Communicate issues or exceptions to other concerned departments as necessary.

Duties and Responsibilities

• Provide claims support by reviewing, researching, investigating, processing and adjudicating claims
• Authorize the appropriate payment or refer/escalate claims to concerned parties for further review.
• Adjudicate claims, analyze validity and identify trends and provide reports if necessary.
• Communicate any discrepancy of claims
• Consistently meets established productivity, schedule adherence and quality standards.
• Suggest any process improvement ideas to team lead that would greatly impact the process.
• Attend any developmental training for career and personal development.

Background and Qualifications

• Candidates must possess at least a Bachelor's/College Degree preferably in health / medical allied courses such as Nursing, Pharmacy, etc.
• At least 2 year(s) of solid working experience in the related field is required for this position.
• With experience working in TPA, HMO, insurance or insurance broker companies.
• Ability to work onsite and extend beyond company operating hours when needed.
• Strong attention to detail and accuracy.
• Outstanding communication (written and oral) and interpersonal skills, as well as have excellent presentation skills.
• Familiar with health insurance / HMO policies and coverages.
• Exceptional critical thinking skills and is able to investigate root causes and recommend solutions.
• Strong organizational, multi-tasking and time-management skills.
• Proven ability to work independently and as a team member.
• Adheres consistently to the RCI values

You may directly send your job application through the link below:

https://cutt.ly/YVfSfII

Reliance United, the Health Services Arm of Unilab provides the opportunity to learn new skills as you progress with your career. Join us as we build a healthier community for Filipinos! Apply today.

https://relianceunited.freshteam.com/jobs

Job Type: Temporary
Contract length: 6 months

Pay: Php18,000.00 - Php25,000.00 per month

Please refer to job description.