Overview

On-site - Makati 3-5 Yrs Exp Bachelor Full-time

Job Description

Medical Reimbursement

Government Mandated Benefits

Insurance Health & Wellness

Health Insurance, Life Insurance, HMO

Responsibilities

• CLAIMS PROCESSING: Ensures accurate review of claims documents like LOA, hospital bills/SOA, concurrent review form, physician’s report, original OR for use in processing claims.
• CLAIMS REVIEW/ EVALUATION/ ADJUDICATION: Reviews/evaluates claims and adjudicates claims to ensure claims are according to benefits plan, coverage and policies and standards.
• CLAIMS APPROVAL: Approves claims according to limits of authority.
• CUSTOMER SERVICE: Ensures provision of quality customer service; maintains good relationships with providers by making regular visits and ensuring timely payment of medical bills, in coordination with other departments; handles inquiries of clients, members ...