DE029770-Claims Management Associate

---ONLY THOSE APPLICANTS WHO ALREADY HAVE THE RIGHT TO LIVE AND WORK IN THIS COUNTRY ARE ELIGIBLE TO APPLY FOR THIS ROLE---

POSITION TITLE: Claims Management Associate

OVERALL PURPOSE:

The Claims Adjudicator is responsible for accurate and timely adjudication of Wellness and Other claims. This may include additional investigation to obtain necessary information (order medical records etc.) to complete the claim review and processing.

RESPONSIBILITIES:

Core Competencies:

Attention to detail

Proven organizational ability

Reliability

Ability to work independently

Medical allied or has medical background

Background or experience in end-to-end claims processing

Communication Skills:

Excellent written and verbal communication skills in English

Remains focused on improving communication skills while continuously enhancing knowledge on client products and services

Possesses strong interpersonal skills

Problem Solving:

Understands the applicable aspects of the client products/services needed to perform their task

Ability to accurately and quickly perform mathematical calculations

Concentrates on fostering processing efficiencies while meeting quality standards

Displays exemplary analysis and problem-solving capabilities

Teamwork

Works well with others

Develops rapport and trust

Participates actively in team discussions and activities

May assist less experienced or temporary staff when appropriate

Client Focus:

Focuses on achieving client and company goals

Flexible and trainable

Aims to maintain excellent relations with the client, client customers (providers), team and internal

Strives to maintain a sound knowledge of the support

Maintains customer focus and service orientation

OTHERS:

Project Shift Schedule: Night Shift

Project Rest Day: Weekends Off

Project/Team Location: Quezon City, Gateway Tower 2

SKILLS AND QUALIFICATIONS:

Graduate with a bachelor’s degree in a health/clinical related field such as nursing, pharmacology, kinesiology, sports medicine or occupational/speech therapy

Open to fresh graduate or no experience

6 months of CSR experience is an advantage

End-to-end claims processing experience is an advantage