Medical claims processor (gov)

Job Description

1. Ensure that claims assigned are completed within turnaround time.
2. Ensures that batches are completed and uploaded.
3. Prioritize completion of PPD, Aging and ASAP Batches
4. Process and adjudicate the claims assigned
5. Evaluate the claims based on Account's Benefits
6. Ensure to meet daily/weekly/monthly target production
7. Ensure that all returned claims from Claims QC -IP are correctly edited
8. Ensures the quality of claims to be submitted for approval.
9. Escalate scanning-related issues.
10. Correct tagging of pending claims
11. Return claims that are not valid for process to provider/hospital
12. Comply with the organization’s information security and data privacy policies, procedures, and

1. Attend mandatory annual Information Security (InfoSec) and Data Privacy Act (DPA) awareness

relevant obligations.

• NO LICENSE OR EXPERIENCE REQUIRED!!!
• DAY SHIFT!
• FRESH GRADUATES ARE ENCOURAGED TO APPLY!!
• Candidate must have a degree in BS-Nursing, Pharmacy, MedTech, Radtech, BS Biology major on medical biology, Nutrition Dietician, Physical therapy, Occupational Therapy, Respiratory Therapy, etc.
• COMPLETED IN 3RD YEAR LEVELS ARE ALSO WELCOME(MUST HAVE SCHOOL RECORDs)
• Shifting schedule.
• Willing to work within Cebu City
• Annual Merit Increase based on the set metrics
• Joining Incentives
• Retention Incentive
• HMO upon regularization
• SL & VL upon regularization

Work location

CEBU CITY (CAPITAL), CEBU

Remarks

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