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...