Job Description
On-site - Makati Fresh Graduate/Student Bachelor Full-time
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Job Description
Government Mandated Benefits
Insurance Health & Wellness
Professional Development
Job Training
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- Responsible for analyzing, adjudicating, auditing, and processing of claims (In-Patient, Outpatient Hospital Bills and Professional Fees) according to set medical guidelines, policies within the agreed SLAs (Service Level of Agreements)
- Analyze claim submissions to verify policyholder and provider information, ensuring accuracy and completeness against submitted documentation.
- Liaise with clients, insurance agents, beneficiaries, healthcare providers, and other departments to gather information, resolve issues, and provide updates on claim status.
- Prepare and maintain accurate records of all claim activities and policy information, often using specialized database systems.
- Determine policy coverag...
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