Opportunity Description
Hybrid - Makati 1-3 Yrs Exp Bachelor Full-time
Job Description
- Assure accurate insurance claims adjudication in a timely manner.
- Assure timely submission of invoices/claims utilization report.
- Validate documents received as well as members' information to adjudicate the claims based on the submitted information.
- Apply the Plan policy and its exclusion as well as underwriting guidelines to determine coverage for claims.
- Deny claims according to SOB, exclusions, and policies.
- Assure timely payment of invoices from providers and ensure all information and documents needed are accurate and complete.
- Keep management aware of members' issues from providers to enhance operations and elevate to higher-ups when necessary.
- Coordinate with providers all Claims unpaid and do reconciliation.
- Answer inquiries and handle complaints from providers.
Top Benefits or Perks
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