17 Claims Processor jobs in the Philippines
0
Claims Processor
Makati, National Capital Region
Prime@Technology Specialists, Inc.
Posted today
Job Viewed
Job Description
**Qualifications**:
- Graduate of any medical allied courses
- Amenable to work in shifting schedule and graveyard shift.
- Willing to work in Makati
- Willing to work 6 days per week
- Ensure that claims assigned are completed within turnaround time. - Ensure that batches are completed and balanced.
- Prioritize completion of PPD, Aging, and ASAP batches.
- Process and adjudicate the claims assigned.
- Evaluate the claims based on the Account’s Benefits.
- Send a daily batches status report.
- Ensure to meet daily/weekly/monthly target quota.
- Ensure that all returned claims from the client are correctly edited.
- Encode the correct payment for Doctors/Hospitals.
- Ensure the quality of claims to be submitted.
- Escalate scanning-related issues.
- Correct tagging of pending claims.
- Return claims that are not valid to process.
**Job Types**: Full-time, Permanent
**Salary**: Php15,000.00 per month
**Benefits**:
- Health insurance
- Opportunities for promotion
- Paid training
- Pay raise
Schedule:
- 8 hour shift
- Day shift
- Evening shift
- Holidays
- Overtime
- Shift system
- Weekends
Supplemental pay types:
- 13th month salary
- Overtime pay
Ability to commute/relocate:
- Makati City: Reliably commute or planning to relocate before starting work (required)
- Graduate of any medical allied courses
- Amenable to work in shifting schedule and graveyard shift.
- Willing to work in Makati
- Willing to work 6 days per week
- Ensure that claims assigned are completed within turnaround time. - Ensure that batches are completed and balanced.
- Prioritize completion of PPD, Aging, and ASAP batches.
- Process and adjudicate the claims assigned.
- Evaluate the claims based on the Account’s Benefits.
- Send a daily batches status report.
- Ensure to meet daily/weekly/monthly target quota.
- Ensure that all returned claims from the client are correctly edited.
- Encode the correct payment for Doctors/Hospitals.
- Ensure the quality of claims to be submitted.
- Escalate scanning-related issues.
- Correct tagging of pending claims.
- Return claims that are not valid to process.
**Job Types**: Full-time, Permanent
**Salary**: Php15,000.00 per month
**Benefits**:
- Health insurance
- Opportunities for promotion
- Paid training
- Pay raise
Schedule:
- 8 hour shift
- Day shift
- Evening shift
- Holidays
- Overtime
- Shift system
- Weekends
Supplemental pay types:
- 13th month salary
- Overtime pay
Ability to commute/relocate:
- Makati City: Reliably commute or planning to relocate before starting work (required)
This advertiser has chosen not to accept applicants from your region.
1
Claims Processor- Makati
Makati City, National Capital Region
Dempsey Resource Management Inc
Posted 14 days ago
Job Viewed
Job Description
• Evaluates claims receive by checking the completeness of documents, necessity and reasonableness of expenses.
• ncoding and simplification of diagnosis-data entry. br>• C nducts routine reconciliation of Outstanding Accounts with Providers to be reported to Provider Relation Department. < r>• E sures that all medical claims documents are properly filed and labeled. < r>• P rform other duties and responsibilities as maybe assigned by the immediate superior. < r>
QUALIFICATIONS:
• P eferably graduate of any medical course < r>• C mputer literate (Knowledgeable in Microsoft Office) < r>• R levant work experience is a plus. < r>• Available for Face to Face/ phone call or virtual interviews. < r>• Reliably commute before starting work (relocation assistance is not provided) < r>
WORK LOCATION:
• Makati City < r>
WORK SCHEDULE:
• Mondays to Fridays (8:30AM - 5:30PM) < r>
SALARY:
• P18,000/mo. (Depends on qualifications) < r>
*FOR DIRECT HIRING*
• ncoding and simplification of diagnosis-data entry. br>• C nducts routine reconciliation of Outstanding Accounts with Providers to be reported to Provider Relation Department. < r>• E sures that all medical claims documents are properly filed and labeled. < r>• P rform other duties and responsibilities as maybe assigned by the immediate superior. < r>
QUALIFICATIONS:
• P eferably graduate of any medical course < r>• C mputer literate (Knowledgeable in Microsoft Office) < r>• R levant work experience is a plus. < r>• Available for Face to Face/ phone call or virtual interviews. < r>• Reliably commute before starting work (relocation assistance is not provided) < r>
WORK LOCATION:
• Makati City < r>
WORK SCHEDULE:
• Mondays to Fridays (8:30AM - 5:30PM) < r>
SALARY:
• P18,000/mo. (Depends on qualifications) < r>
*FOR DIRECT HIRING*
This advertiser has chosen not to accept applicants from your region.
2
Claims Processor - Urgent
Makati, National Capital Region
Dempsey Resource Management Inc.
Posted 18 days ago
Job Viewed
Job Description
Monthly Salary: PHP 18,000
Work Schedule: Monday to Friday br>Working Hours: 8:30 am to 5:30 pm
Work Location: Makati Office
Job Qualifications:
Educational Background:
Bachelor’s degree in Business administration, Healthcare Management, Nursing, or a related field is preferred.
Experience:
-2 years of relevant experience in medical claims processing or administrative support in healthcare, hospitals, clinics, or insurance/HMO industries. < r> amiliarity with medical billing and reimbursement processes. < r> xperience working with HMO procedures and healthcare provider networks is a plus. < r>
Skills:
ttention to Details: Accurate and thorough in reviewing medical claims, documents, and codes. < r> nalytical Thinking: Ability to interpret policy coverage, medical reports, and supporting documents to identify discrepancies or irregularities. < r> ommunication: Strong written and verbal communication skills to coordinate with hospitals, clinics, and policyholders. < r> echnical Proficiency: Proficient in medical claims processing systems, Microsoft Excel, MS Word, and email platforms. < r> roblem-solving: Capable of investigating claims issues and resolving them in a timely and efficient manner. < r>
Other Qualifications:
amiliarity with ICD, CPT, and HCPCS codes and medical terminology. < r> nowledge of insurance guidelines, HMO processes, and regulatory compliance. < r> bility to multitask and work efficiently under time constraints. < r> xcellent organizational and documentation skills. < r>
Job Specifications:
Claims Processing:
eview and process medical claims submitted by members or healthcare providers. < r> heck documents for completeness, including medical abstracts, itemized statements, and official receipts. < r> erify member eligibility, benefits coverage, and policy limits. < r> pply appropriate coding and benefits computation based on the member’s plan and HMO rules.
Data Entry & Record Keeping:
ode claims data into the medical claims processing system. < r> aintain updated records of approved, denied, and pending claims. < r> ocument any adjustments, follow-ups, and discrepancies. < r>Claims Evaluation:
valuate claims against policy provisions and clinical guidelines. < r> etect potential fraud, abuse, or claim duplication. < r> oordinate with medical providers to validate unclear or questionable claims. < r> ccurately calculate payable amounts, co-pays, and exclusions. < r>
NOTE: THIS IS DIRECT HIRE AND NOT UNDER AGENCY
Work Schedule: Monday to Friday br>Working Hours: 8:30 am to 5:30 pm
Work Location: Makati Office
Job Qualifications:
Educational Background:
Bachelor’s degree in Business administration, Healthcare Management, Nursing, or a related field is preferred.
Experience:
-2 years of relevant experience in medical claims processing or administrative support in healthcare, hospitals, clinics, or insurance/HMO industries. < r> amiliarity with medical billing and reimbursement processes. < r> xperience working with HMO procedures and healthcare provider networks is a plus. < r>
Skills:
ttention to Details: Accurate and thorough in reviewing medical claims, documents, and codes. < r> nalytical Thinking: Ability to interpret policy coverage, medical reports, and supporting documents to identify discrepancies or irregularities. < r> ommunication: Strong written and verbal communication skills to coordinate with hospitals, clinics, and policyholders. < r> echnical Proficiency: Proficient in medical claims processing systems, Microsoft Excel, MS Word, and email platforms. < r> roblem-solving: Capable of investigating claims issues and resolving them in a timely and efficient manner. < r>
Other Qualifications:
amiliarity with ICD, CPT, and HCPCS codes and medical terminology. < r> nowledge of insurance guidelines, HMO processes, and regulatory compliance. < r> bility to multitask and work efficiently under time constraints. < r> xcellent organizational and documentation skills. < r>
Job Specifications:
Claims Processing:
eview and process medical claims submitted by members or healthcare providers. < r> heck documents for completeness, including medical abstracts, itemized statements, and official receipts. < r> erify member eligibility, benefits coverage, and policy limits. < r> pply appropriate coding and benefits computation based on the member’s plan and HMO rules.
Data Entry & Record Keeping:
ode claims data into the medical claims processing system. < r> aintain updated records of approved, denied, and pending claims. < r> ocument any adjustments, follow-ups, and discrepancies. < r>Claims Evaluation:
valuate claims against policy provisions and clinical guidelines. < r> etect potential fraud, abuse, or claim duplication. < r> oordinate with medical providers to validate unclear or questionable claims. < r> ccurately calculate payable amounts, co-pays, and exclusions. < r>
NOTE: THIS IS DIRECT HIRE AND NOT UNDER AGENCY
This advertiser has chosen not to accept applicants from your region.
3
Claims Processor - Makati
Makati, National Capital Region
Dempsey Executive Search
Posted 19 days ago
Job Viewed
Job Description
Claims Processor - Makati
Salary: ₱18,000 br>Job Category: Insurance / Risk Management
Job Level: Entry Level
Qualifications:
Bachelor's degree
1-2 years claims processing
Medical coding knowledge
X.
Salary: ₱18,000 br>Job Category: Insurance / Risk Management
Job Level: Entry Level
Qualifications:
Bachelor's degree
1-2 years claims processing
Medical coding knowledge
X.
This advertiser has chosen not to accept applicants from your region.
4
Claims Processor (HMO)
Caloocan City, National Capital Region
Triple Star Staffing Center Inc.
Posted 20 days ago
Job Viewed
Job Description
Triple Star Staffing Center, Inc. is looking for a Claims Processor that will handle HMO insurance claims.
br>Responsibilities:
-Review and evaluate medical claims for completeness and accuracy.
-Responsible for processing of payments, insurance and HMO claims.
-Reviewing claims for accuracy, completeness, and compliance with policies and regulations.
Qualifications:
-Bachelor's degree in any course or Allied Health and equivalent.
-With basic knowledge in billing process and insurance protocols.
-Able to handle sensitive information with confidentiality.
-With strong analytical and problem-solving skills.
-Preferably with familiarity in medical terminology and healthcare processes.
-Proficiency in MS Office.
Rate:
20,000 - 25,000 (Negotiable)
Area of assignment:
Bagong Barrio, Caloocan City
br>Responsibilities:
-Review and evaluate medical claims for completeness and accuracy.
-Responsible for processing of payments, insurance and HMO claims.
-Reviewing claims for accuracy, completeness, and compliance with policies and regulations.
Qualifications:
-Bachelor's degree in any course or Allied Health and equivalent.
-With basic knowledge in billing process and insurance protocols.
-Able to handle sensitive information with confidentiality.
-With strong analytical and problem-solving skills.
-Preferably with familiarity in medical terminology and healthcare processes.
-Proficiency in MS Office.
Rate:
20,000 - 25,000 (Negotiable)
Area of assignment:
Bagong Barrio, Caloocan City
This advertiser has chosen not to accept applicants from your region.
5
Claims Processor (Davao)
Paramount Life & General Insurance Corporation
Posted today
Job Viewed
Job Description
The position is responsible for ensuring efficiency, accuracy of claims processing and settlements as part of servicing to our agents and clients’ insurance claims of all lines in accordance with company policies and guidelines within the accepted loss evaluation in a timely manner.
- Data entry - receives claims documents from clients and books the same to the claims monitoring system, updating the system on a regular basis (for settled/denied claims)
- Document verification - verifying claims documents submitted in support of the claim to check the authenticity of documents.
- Claim verification - personal visit to claimants to check and assess the claim
- Other task to be assigned from time to time
**Minimum Requirements**:
- At least 1 Year(s) of working experience in the related field is required for this position.
- Preferably with background in Non-life Insurance
- Knowledgeable in Microsoft office program (Excel, Word, etc),
- With good communication skills
- Willing to work in Davao City
**Job Types**: Full-time, Permanent
**Salary**: Php10,000.00 - Php14,000.00 per month
**Benefits**:
- Additional leave
- Company events
- Health insurance
- Life insurance
Schedule:
- 8 hour shift
- Monday to Friday
Supplemental pay types:
- 13th month salary
Ability to commute/relocate:
- Makati City: Reliably commute or planning to relocate before starting work (required)
**Education**:
- Bachelor's (required)
**Experience**:
- Non-Life Insurance: 1 year (preferred)
- claims processing: 1 year (preferred)
- Data entry - receives claims documents from clients and books the same to the claims monitoring system, updating the system on a regular basis (for settled/denied claims)
- Document verification - verifying claims documents submitted in support of the claim to check the authenticity of documents.
- Claim verification - personal visit to claimants to check and assess the claim
- Other task to be assigned from time to time
**Minimum Requirements**:
- At least 1 Year(s) of working experience in the related field is required for this position.
- Preferably with background in Non-life Insurance
- Knowledgeable in Microsoft office program (Excel, Word, etc),
- With good communication skills
- Willing to work in Davao City
**Job Types**: Full-time, Permanent
**Salary**: Php10,000.00 - Php14,000.00 per month
**Benefits**:
- Additional leave
- Company events
- Health insurance
- Life insurance
Schedule:
- 8 hour shift
- Monday to Friday
Supplemental pay types:
- 13th month salary
Ability to commute/relocate:
- Makati City: Reliably commute or planning to relocate before starting work (required)
**Education**:
- Bachelor's (required)
**Experience**:
- Non-Life Insurance: 1 year (preferred)
- claims processing: 1 year (preferred)
This advertiser has chosen not to accept applicants from your region.
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6
Claims Processor -Makati Area
Makati, National Capital Region
Dempsey Inc
Posted 22 days ago
Job Viewed
Job Description
GRADUATE OF MEDICAL COURSE
br>Salary Offer : P16,000.00-P18,000.00
• Evaluates claims receive by checking the completeness of documents, necessity and reasonableness of expenses. < r>• Encoding and simplification of diagnosis-data entry. < r>• Conducts routine reconciliation of Outstanding Accounts with Providers to be reported to Provider Relation Department. < r>• Ensures that all medical claims documents are properly filed and labeled. < r>• Performs other duties and responsibilities as maybe assigned by the immediate superior < r>Qualifications:
• Graduate of Bachelors of Science, medical course is a plus. < r>• Computer literate (Knowledgeable in Microsoft Office,Excel) < r>• With HMO/Hospital/Clinic work experience is a plus. < r>• Background in encoding.
br>Salary Offer : P16,000.00-P18,000.00
• Evaluates claims receive by checking the completeness of documents, necessity and reasonableness of expenses. < r>• Encoding and simplification of diagnosis-data entry. < r>• Conducts routine reconciliation of Outstanding Accounts with Providers to be reported to Provider Relation Department. < r>• Ensures that all medical claims documents are properly filed and labeled. < r>• Performs other duties and responsibilities as maybe assigned by the immediate superior < r>Qualifications:
• Graduate of Bachelors of Science, medical course is a plus. < r>• Computer literate (Knowledgeable in Microsoft Office,Excel) < r>• With HMO/Hospital/Clinic work experience is a plus. < r>• Background in encoding.
This advertiser has chosen not to accept applicants from your region.
7
Claims Processor (HMO Company) Makati
Makati, National Capital Region
DEMPSEY RESOURCE MANAGEMENT INC
Posted 21 days ago
Job Viewed
Job Description
Job Qualifications:
Educational Background: br> Bachelor’s degree in business administration, Healthcare Management, Nursing, or a related field is preferred.
Experience:
-2 years of relevant experience in medical claims processing or administrative support in healthcare, hospitals, clinics, or insurance/HMO industries. < r> amiliarity with medical billing and reimbursement processes. < r> xperience working with HMO procedures and healthcare provider networks is a plus.
Educational Background: br> Bachelor’s degree in business administration, Healthcare Management, Nursing, or a related field is preferred.
Experience:
-2 years of relevant experience in medical claims processing or administrative support in healthcare, hospitals, clinics, or insurance/HMO industries. < r> amiliarity with medical billing and reimbursement processes. < r> xperience working with HMO procedures and healthcare provider networks is a plus.
This advertiser has chosen not to accept applicants from your region.
8
Insurance / Claims Analysts - (Onsite)
Cebu, Cebu
Staff Outsourcing Solutions
Posted 6 days ago
Job Viewed
Job Description
REQUIREMENTS:
br>Experience working as a representative of the providers or members line for queries in eligibility and benefits, claims, and authorizations.
Preferably with experience in inpatient or outpatient services.
Must know the basic insurance terms.
Knowledge in Medical Billing/Claims.
Experience in Revenue Cycle Management (or a part of) required.
The job will be a mix of insurance payment collections, reports generation and phone calls (only 10% calls, or maybe less!).
Basic knowledge in Word and Excel is required. Knowledge in Google sheet a plus.
JOB RESPONSIBILITIES:
- Follow-Up with Insurance Carriers via all mediums to determine reason for claims denial and work to resolve medical claims for payment.
- Research problem accounts to ensure accuracy
- Ability to resolve insurance denials and file appeals with government and commercial carriers.
- Analyze the unpaid medical claims and denials and identify/investigate the reasons for nonpayment and which action is needed to resolve timely.
- Adheres to applicable policies, hospital/physician billing/departmental practices and 3rd party requirements.
- Denial Management--analyzing and resolving denied claims. Investigate the reasons for denials, identify errors or discrepancies, and take corrective actions, such as submitting appeals
EXCITING PERKS for successful hires.
Earn 40k up to 65k per month
This is an office-based position located in Cebu Business Park.
Work hours will be US Eastern time. FIXED WEEKENDS OFF.
STAFF OUTSOURCING SOLUTIONS
br>Experience working as a representative of the providers or members line for queries in eligibility and benefits, claims, and authorizations.
Preferably with experience in inpatient or outpatient services.
Must know the basic insurance terms.
Knowledge in Medical Billing/Claims.
Experience in Revenue Cycle Management (or a part of) required.
The job will be a mix of insurance payment collections, reports generation and phone calls (only 10% calls, or maybe less!).
Basic knowledge in Word and Excel is required. Knowledge in Google sheet a plus.
JOB RESPONSIBILITIES:
- Follow-Up with Insurance Carriers via all mediums to determine reason for claims denial and work to resolve medical claims for payment.
- Research problem accounts to ensure accuracy
- Ability to resolve insurance denials and file appeals with government and commercial carriers.
- Analyze the unpaid medical claims and denials and identify/investigate the reasons for nonpayment and which action is needed to resolve timely.
- Adheres to applicable policies, hospital/physician billing/departmental practices and 3rd party requirements.
- Denial Management--analyzing and resolving denied claims. Investigate the reasons for denials, identify errors or discrepancies, and take corrective actions, such as submitting appeals
EXCITING PERKS for successful hires.
Earn 40k up to 65k per month
This is an office-based position located in Cebu Business Park.
Work hours will be US Eastern time. FIXED WEEKENDS OFF.
STAFF OUTSOURCING SOLUTIONS
This advertiser has chosen not to accept applicants from your region.
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