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Claims Assistant - Medical Claims

Medical Claims

Makati, National Capital Region ·  More than 30 days

M2MJ Human Resources Consulting

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  • Description

  • Job Functions:

    • Check availability and accuracy of claims details.

    • Make necessary corrections of claims details.

    • Verify unlisted claims in System with biller.

    • Process claims using the prescribed process and based on existing guidelines.

    • Prepare transmittal of claims for check preparation.

    • Approve payment for claims within the authority limit.

    • Recommend approval of claims payment beyond authority limit.

    • Prepare and submit Claims Statement and Statement of Account to biller for bill back of excess of

    benefits to client or company.

    • Turn over complete claims documents to Front Desk for proper filing.

    • Answer inquiries via email or phone regarding status of claims or overdue payments.

    • Documentation of medical claims disputes or complaints.

    • Resolution or escalation of claims disputes or complaints.

    • Coordination with sales and other work units regarding non-claims related customer concerns received

    via email or phone.

    Job Requirements:

    • Must be a College Graduate with Degree in any Medical or Business-Related discipline.

    • With at least (2) years of experience in Medicals or Life Claims processing.

    • Proficient in using Microsoft Office Applications – MS Word, Excel.

    • Analytic and keen to details.

    • Preferably passed Life Office Management Association (LOMA) courses.

  • Requirements

  • Minimum education level: Bachelor´s Degree
  • Years of experience: 2
  • Language(s): English ,Tagalog
  • Availability for travel: No
  • Availability for change of residence: No
  • People with disabilities: Yes

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Job summary

  • Claims Assistant

  • Makati, National Capital Region

  • Company

    M2MJ Human Resources Consulting
  • Type of contract

    Permanent contract

  • Work type

    Full Time

  • Apply