Quality Manager - Healthcare, Healthcare

Manila, Metropolitan Manila Amazon

Posted 6 days ago

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Job Description

Description
The ideal candidate should have an extensive experience in quality with an understanding of Accounts Receivable Operations processes within Healthcare - RCM. He/she should have high-attention to details, reporting skills in presenting accuracy scores, error trends and other notable observations during audits. He/she must be able to identify areas of improvements in the process, assess complex problems and conduct root causes of these process opportunities. Should be knowledgeable in Operational Excellence, attended Quality related trainings or LEAN Six Sigma basics. Can propose and work on continuous improvement/initiative projects based on opportunities identified during audits. Has confidence to interact with higher management inside or outside the Amazon Manila office.
Key job responsibilities
Key job responsibilities
Responsibilities include, but are not limited to:
Auditor will have to conduct spot checks on a monthly basis based on existing quality parameters.
Provide progress reports to leadership teams regarding quality results and action items on quality misses.
Discuss results of audits on a monthly basis.
Analyze and monitor trends and root causes on audit observations.
Participate in special projects as requested by Leadership.
Provide inputs or recommendations for quality opportunities and action plans.
Basic Qualifications
- Graduate of a Bachelors Degree
- Experience with US healthcare and health insurance industry.
- Prior experience of 2-5 years in a Quality role in a shared service financial operation.
- Prior experience of at least 5 years in Accounts Receivable or Finance & Accounting role as an Analyst/Specialist/Process Analyst/Quality Analyst
- Strong knowledge in Accounts Receivable / Order to Cash/ Credit control is needed
- Proficient with MS Outlook, Word and Excel or similar desktop applications.
- Has experience preparing weekly and monthly reports thru MS Excel w/ pivot table summaries
- Has been part of a team that worked on a Six Sigma belt project / Kaizen / Lean projects
- Willing to work in Mid/Night and/or shifting schedule.
- Exemplified traits of being a team player thru leading initiatives.
- Ability to work under tight deadlines and high pressure.
Preferred Qualifications
- Preferably with a Bachelor Degree in Finance/Accounting as Major Subject.
- Subject matter expertise on US healthcare RCM (Collections, Cash Appm, Charge Capture).
- Has excellent root cause analysis or problem-solving skills.
- Experience in 6 sigma Methodologies- Participated in Lean Projects, Quality circles & Creative work groups.
- Preferably has working knowledge on Oracle Financials, SAP, Collection Workflow Tools or other Finance ERP tools
- Experience working with multi-cultural, multi-national peer group.
- Excellent organizational and time-management skills
- Knowledge of Healthcare business
Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit for more information. If the country/region you're applying in isn't listed, please contact your Recruiting Partner.
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FinOps Manager - AR HealthCare, HealthCare

Manila, Metropolitan Manila Amazon

Posted 6 days ago

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Job Description

Description
The Finance Operations organization works with every part of Amazon to provide operations accounting and operations excellence services with the highest level of controller-ship at the lowest cost to the company. We provide the backbone systems and operational processes which completely, accurately, and validly pay Amazon's suppliers, invoice our customers and report financial results. Amazon is quickly building the Finance Operations capabilities in the healthcare industry by creating the Healthcare Finance Operations Services.
As part of the Healthcare Finance Operations Services team, you will find yourself working with exceptionally talented and determined people committed to driving financial improvement, scalability, and process excellence. To support the growth of Amazon Healthcare, this candidate must possess a strong passion for accountability, setting high standards, raising the bar, and driving results through constant focus on improving existing and future state operations, systems, and processes in collaboration with Management.
As the Healthcare Finance Operations Manager, you will have oversight of the people, process, and technology functions for medical revenue cycle operations including, but not limited to, billing, claims management and AR management.
The ideal candidate will have prior leadership experience in Revenue Cycle Management - Medicare. You are experienced in ensuring compliance with applicable regulations and developing mechanisms for operational adherence to these policies.
This is both a strategic and a hands-on role that requires strong leadership skills, a high degree of organization, strong written and verbal communication, and a passion for collaboration in the design of data driven programs that optimize reimbursement and revenue and with a focus on the shared services functions. The Manager will have a deep knowledge of the healthcare industry, or a willingness to learn.
Key job responsibilities
- Lead a team that proactively reaches out to patients with open balances and assisting them with payment options
- Partner with admin team on member's billing needs via 1Life's tasking system to provide the best customer service
- Educating admins and patients to better understand health insurance benefits through open balances
- Escalation point on answering patient inquiries for complex billing cases and questions
- SME for claims investigation through insurance to ensure they were processed according to the patient benefit plan via internal tools
- Reaching out to patients when bill payments were unable to be processed (i.e. bounced checks, declined cc's) to offer options for resolution
- Supporting One Medical through processes aimed at empowering our patients to resolve any financial responsibilities
- Reviewing and reconciling patient and insurance balances for accuracy
- Managing the member statement process, by ensuring bills are efficiently and accurately sent
- Maintaining teams service level agreements in response time to admins and patients
Basic Qualifications
- Bachelors degree in a relevant area of expertise in Healthcare RCM. - Minimum of 2 years of progressively responsible revenue cycle management with strong working knowledge of Medicare. - Financial management skills including the ability to financially analyze data for operations, auditing, and forecasting; basic accounting knowledge; staffing and financial reporting skills. - Experience leading cross-org discussions and working with a matrixed team of stakeholders to achieve common goal. - Excellent written, presentation and verbal communication skills at the executive level. - Proven track record of taking ownership and driving results. - Strong bias for action and be able to work iteratively. - Possesses an exceptional eye for detail and process improvement.
- Bachelors degree in a relevant area of expertise in Healthcare RCM. - Minimum of 3 years of progressively responsible revenue cycle management with strong working knowledge of Medicare. - Financial management skills including the ability to financially analyze data for operations, auditing, and forecasting; basic accounting knowledge; staffing and financial reporting skills. - Experience leading cross-org discussions and working with a matrixed team of stakeholders to achieve common goal. - Excellent written, presentation and verbal communication skills at the executive level. - Proven track record of taking ownership and driving results. - Strong bias for action and be able to work iteratively. - Possesses an exceptional eye for detail and process improvement.
Preferred Qualifications
- - Multi-state, federal and jurisdictional payor and reimbursement experience. - Project management experience. - Global process management working across multiple time zones. - Must possess solid analytical skills and be able to make quick, effective decisions under pressure. - Strong critical thinking skills with ability to challenge normal operations. - Trained in HIPAA guidelines.
Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit for more information. If the country/region you're applying in isn't listed, please contact your Recruiting Partner.
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Healthcare Account

Guadalupe Viejo, National Capital Region ₱250000 - ₱300000 Y Sapient Global Services - ALABANG

Posted today

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Job Description

We're growing and we want YOU to be part of our Customer Service Representative team in Metro Manila

Experience a one-day hiring process and salary offer up to 25K plus monthly commissions

Your Day-to-Day:

Handle customer inquiries, provide solutions, and resolve issues across various channels.

Offer accurate information about products, services, and company policies.

Process orders, returns, and account updates efficiently.

Maintain high standards of customer service and satisfaction.

Meet performance targets for productivity, quality, and customer satisfaction.

Document interactions and transactions accurately.

Qualifications:

High school diploma or equivalent required; customer facing work experience is a plus.

No prior customer service experience necessary—we provide comprehensive training

Strong communication and interpersonal skills.

Attention to detail and effective problem-solving abilities.

Ability to work in a fast-paced environment and adapt to changing customer needs.

Proficiency with customer service tools and systems is a plus but not required.

Why You Should Apply:

Competitive Salary (up to 25K)

Monthly Commissions

Fast-Track Career Growth for top performers

HMO with 2 FREE Dependents from Day 1

Free Coffee and Biscuits at the office (because work should be enjoyable)

Pioneer Accounts (including Non-voice and Easy Accounts)

Incentives, Signing Bonuses, and More Premium Perks

Flexible Shifts (Day, Mid, and Night)

Life Insurance & Retirement Plan for qualified team members

Work-life balance is real here. Join a team that values growth, fun, and making a difference. Whether you're new to customer service or looking to elevate your career, we have a place for you

Ready to take your career to the next level? Let's chat about how you can grow with us—apply today

Job Types: Full-time, Permanent, Fresh graduate

Pay: Up to Php25,000.00 per month

Benefits:

  • Additional leave
  • Flexible schedule
  • Flextime
  • Free parking
  • Health insurance
  • Life insurance
  • Opportunities for promotion
  • Paid training
  • Pay raise
  • Promotion to permanent employee

Work Location: In person

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CSR: HEALTHCARE

Taguig, National Capital Region ₱31000 - ₱100000 Y Nezda Technologies, Inc.

Posted today

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Job Description

Join Sun Life Financial (Philippines) – Be the Voice of Care in Healthcare

Are you ready to make a meaningful impact in people's lives while advancing your career in one of the most trusted financial and healthcare brands worldwide? Sun Life Financial is looking for passionate and experienced Client Care Representatives to join our Healthcare Account.

This is more than just a job — it is your chance to grow, thrive, and belong in a company that values excellence, compassion, and innovation.

Why Sun Life? – Our Promise to You

At Sun Life, you don't just build a career—you build a brighter future. We believe our people are our greatest strength, and we ensure they are empowered, supported, and rewarded through:

  • Security & Growth – Competitive pay, guaranteed bonuses, and clear pathways for career advancement.
  • Health & Well-being – Day 1 HMO coverage (including 2 dependents) and free life insurance & retirement plan.
  • Flexibility & Balance – Hybrid work setup with company-provided equipment, plus weekends off to recharge.
  • Recognition & Rewards – Performance bonuses, 13th & 14th-month pay, and premium holiday pay.
  • Global Impact – Be part of a global brand trusted in Canada, US, and across the world — where your voice contributes to improving lives.
Work Conditions:
  • Account: Healthcare (Insurance | Claims | Benefits | Eligibility)
  • Location: BGC, Taguig City
  • Setup: Hybrid (with equipment provided)
  • Schedule: Night shift, weekends off
What You Will Bring:
  • At least 2 years of college completed.
  • 1+ year of solid international BPO healthcare voice account experience.
  • Strong background in insurance, claims, benefits, or eligibility.
  • Excellent communication skills and ability to deliver exceptional service.
  • Proven track record of meeting performance metrics (AHT, CSAT, QA).
What Awaits You:
  • Salary starting at ₱31, % Night Differential.
  • HMO Day 1 (including 2 dependents).
  • Hybrid setup with provided equipment.
  • Retirement plan + life insurance for free.
  • 13th & 14th-month pay + annual performance bonus.
  • Double pay on holidays.
  • Weekends off – because we value your personal time.

Take the next step toward a career that truly cares — for clients and for you.

The entire hiring process is 100% virtual for your convenience.

Apply Now:

  • Send your application to:
  • Subject Line: Full Name | CCR: Healthcare | BGC, Taguig
  • Email Body: Contact Number | Current Location | Date of Birth | Expected Salary

At Sun Life, your future shines brighter. Join us and be part of a company where care meets career.

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Healthcare Agents

Taguig, National Capital Region ₱250000 - ₱500000 Y UST

Posted today

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Job Description

  • The Customer Service Associate will provide exceptional customer service to UST customers via inbound Call Center Operations
  • Receive and respond to inbound phone calls for customer assistance
  • Respond to outbound phone call requests
  • Document all calls in ticketing and tracking systems
  • Respond to customer inquiries and provide data to customers within a required time frame
  • Act as liaison between claims department and providers
  • Research customer claims in the primary payor systems
  • Ensure highest level of customer service on every call
  • Perform other duties as assigned or necessary
  • Maintain a full comprehensive understanding of the covered benefits, coding and reimbursement policies and contracts

Required Skills/Abilities

  • High school degree required; college level an advantage
  • At least 1 year of contact center experience
  • Knowledge of physician practice and hospital coding, billing and medical terminology, CPT, HCPCS, ICD-9 and ICD-10 an advantage
  • Excellent verbal and written communication skills.
  • Good Attention to detail and problem solving skills
  • Proficiency with MS Office applications, especially Word and Excel
  • Amenable to full onsite work (McKinley)
  • Hired candidates will be provided project completion bonus at the end of contract term (4-5 months)
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Healthcare Specialist

Makati City, National Capital Region ₱40000 - ₱60000 Y Spoke

Posted today

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Job description

About Our Client

Our client is a modern benefits platform and full-service brokerage firm committed to helping companies create healthier workplaces. They combine expertise from benefits firms, technology startups, and insurance carriers to deliver a range of innovative solutions that empower employers and employees alike. Licensed in all 50 states, our client maintains strong relationships with major insurance carriers, providing comprehensive and reliable services. Their signature app serves as a go-to resource for employees, offering easy access to benefits information, tools, and resources to help members thrive.

About the Role

The Advocate will be responsible for resolving member inquiries related to claims, coverage, plan details, eligibility, and authorizations. This role involves utilizing internal systems, process flow documents, and a ticketing system to address member issues and proactively identify additional service needs. The ideal candidate will have excellent communication skills, strong organizational abilities, and a passion for providing exceptional customer service. Adaptability, teamwork, and the ability to learn quickly are essential for success in this role.

Key Responsibilities

  • Provide high-quality customer support to ensure member satisfaction.
  • Maintain a positive, empathetic, and professional attitude with customers at all times.
  • Respond promptly and accurately to member inquiries via phone, service platform, and email.
  • Resolve inquiries related to claims, appeals, providers, benefits, costs, and more.
  • Document resolutions, member communications, and resolution times in the ticketing system.
  • Collaborate with internal consultants and the service team to resolve issues.
  • Reach out to carriers and providers for additional information as needed.
  • Navigate internal systems to gather member, plan, and group details.
  • Advise members on plan selection based on individual and financial needs.
  • Schedule provider appointments on behalf of members.

Requirements

  • 3+ years of experience in customer support, preferably in healthcare and claims.
  • Proven ability to provide exceptional customer service with a focus on empathy and problem-solving.
  • Strong written and verbal communication skills in English, including tone matching and empathy.
  • Ability to multitask and prioritize effectively in a fast-paced environment.
  • Ability to work independently and collaboratively within a team.
  • Strong attention to detail with a focus on accuracy in all tasks.
  • College degree preferred, or completion of at least 2 years of college education.

Work Conditions

  • Salary: Competitive compensation based on experience.
  • Equipment: All necessary equipment will be provided.
  • Workstation: Your workstation should be set up in a safe and secure home environment with stable and reliable internet (minimum speed of 25 Mbps).
  • Work Setup: Hybrid Setup (1x in a week)
  • Working Hours: Monday to Friday, US Hours Required.

Benefits

  • HMO Healthcare Coverage: Comprehensive coverage for you.
  • Leave Days: 20 combined Sick Leave (SL) and Vacation Leave (VL).
  • Government-Mandated Benefits: All mandatory benefits are included.
  • Public Holidays: Paid time off for all Philippines Public Holidays.

What's Next?

Click "Apply" and attach your CV. We look forward to hearing from you

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Healthcare Analyst

Makati City, National Capital Region ₱250000 - ₱500000 Y Strategic Staffing Solutions

Posted today

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Job Description

STRATEGIC STAFFING SOLUTIONS (S3)

Position
: Clinical Claims Processor

Work Set-Up
: Onsite

Office Location:
Makati City

Schedule:
Night Shift (EST)

JOB RESPONSIBILITIES

As a
Claims Processor
, you will be responsible for accurately processing both manual and electronic claims, meeting production goals, ensuring high-quality standards, adhering to compliance policies, fostering a positive work environment, and actively contributing to continuous improvement efforts within the claims processing workflow and department.

Claims Processors
are handling clinical claims; this role is critical in ensuring the accurate and efficient processing of medical insurance claims.

RESPONSIBILITIES:

  • Inputting documents into the system accurately and efficiently.
  • Ensuring high-quality data entry with minimal errors.
  • Correcting errors in electronic claims efficiently.
  • Ensuring accuracy in claim corrections to prevent delays and incorrect payments or denials.
  • Adhering to compliance policies while handling sensitive health documents.
  • Maintaining a positive attitude towards colleagues for a collaborative work environment.
  • Communicating all findings and suggestions for work improvement to enhance overall efficiency and quality.

REQUIREMENTS:

  • At least Senior High/College Level.
  • At least 2 years of solid experience in US Healthcare (Clinical claims processing)
  • Excellent English Communication Skills (Verbal and Written)
  • Excellent organizational skills and attention to detail.
  • Very good communication and customer service orientation.
  • Problem-solving skills by working independently and in collaboration with other teams.
  • Previous experience in the medical field or similar role would be an advantage.
  • Amenable to working on a full-time night shift.
  • Adaptive, open to learning, and can work in fast-paced environment.
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Healthcare Account

Mandaluyong, National Capital Region ₱144000 - ₱360000 Y Telesys

Posted today

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Job Description

1-DAY HIRING PROCESS SAME DAY JOB OFFER

Job Summary:

Join as a Call Center Agent and be the first point of contact for customers. Handle inquiries, resolve issues, and provide excellent service to ensure a positive experience.

Qualifications:

  • High school diploma (college preferred).
  • Excellent verbal and written communication skills.
  • With or without BPO experience
  • Ability to handle high call volumes in a fast-paced setting.
  • Customer service experience is a plus (training provided).
  • Willing to work shifts, including evenings, weekends, and holidays.

Benefits:

  • Competitive salary + performance incentives
  • Health & dental insurance
  • Paid time off (vacation & sick leave)
  • Career growth & professional development
  • Employee wellness programs & product discounts
  • Inclusive and dynamic work environment

Apply Now

If you're passionate about helping people and thrive in a fast-paced setting, join us today and be part of an exceptional customer service team

Job Types: Full-time, Permanent, Fresh graduate

Pay: Php18, Php28,000.00 per month

Benefits:

  • Additional leave
  • Free parking
  • Health insurance
  • On-site parking
  • Paid training
  • Pay raise

Work Location: In person

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Healthcare Account

Marikina City, National Capital Region ₱336000 Y Sapient Global

Posted today

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Job Description

We are mass hiring Call Center Agents across our Metro Manila sites Earn Up to 28K Monthly + 30K Sign-On Bonus. Open for applicants with NO BPO EXPERIENCE.

Job Responsibilities:

  • Ensure precise and transparent communication about healthcare services, insurance coverage, billing, and appointment scheduling.
  • Promptly and effectively address customer concerns, including billing issues, insurance claims, and service-related complaints.
  • Accurately record and update patient details in the healthcare management system.
  • Inform customers of any updates or modifications to healthcare policies, procedures, or insurance plans.

Why Join Us?

  • Competitive Salary – Up to 28K
  • Exciting 30K Sign-On Bonus
  • Flexible shifts – Day, Night, and Graveyard
  • Options for Voice and Non-Voice Accounts
  • Opportunities in Local and International Accounts

URGENT HIRING Apply today and get hired immediately

Job Types: Full-time, Permanent, Fresh graduate

Pay: Up to Php28,000.00 per month

Benefits:

  • Additional leave
  • Company events
  • Flexible schedule
  • Free parking
  • Gym membership
  • Health insurance
  • On-site parking
  • Opportunities for promotion
  • Paid training
  • Pay raise
  • Promotion to permanent employee

Work Location: In person

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Healthcare CSR

Taguig, National Capital Region ₱900000 - ₱1200000 Y Cognizant Technology Solutions Philippines Inc.

Posted today

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Job Description

Basic Qualifications:

  • At least 2nd year college undergraduate with no back subjects
  • Amenable to work onsite in Taguig
  • Amenable to work on a night shift schedule
  • Amenable to work for a voice campaign
  • With experience in working for a Healthcare account

Job Duties:

  • Individuals in this role are responsible for data capture, data validation and updating relevant applications as per the defined process in addition to meeting TAT and maintaining accuracy in day-to-day transaction processing in client/internal applications process flows
  • They are expected to transcribe information from a variety of sources into a standardized database system using various applications based on certain pre-defined rules
  • They may also be assigned with the generation of internal and external reports as applicable in the account
  • They may also assist with activities associated with a health data management team nurse review team or physician review team as specified by effective SOW
  • Edit resolution and adjudication of claims across Commercial  Medicare and Medicaid for Individual and Group businesses. They need to undergo training on Medical and Institutional claims across these LOBs
  • Responsible for Line item coding, Charge Entry Cash Posting and Denial Management areas
  • Process enrollment and disenrollment of members by reviewing/evaluating enrollment forms accurately entering all group subscriber and member information into the system database and ensuring that all change requests are consistent with applicable laws rules and contracts
  • Required to lead coordinate and participate in various queues as required by the business
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