Medical Claims Liaison Officer - Quezon City

Start Date: ASAP

Job Responsibilities:

• Communicate effectively and proactively with PPN Providers to collect and check for completeness and forward claims; following clear and concise guideless, ensuring that each claim is reviewed against approved templates and ensuring that claims will be properly submitted and accepted for processing and timely payment.
• Manage and maintain accurate spreadsheets and other tracking tools to record and monitor progress of claims for each Network Provider; ensuring that claims are accurately and continuously recorded, monitored, and traced throughout the claims processing from initial entry and scanning until payment to the provider.
• To maintain strict privacy, discretion and confidentiality when working with protected health information at all times, adhering to HIPPA guidelines.
• To work with the Global 24 Network Area Supervisors to help educate PPN Providers at all levels of the claims process.
• Work with The Philippines Certification Program Team to understand the vital role of Program Integrity in the claims process.
• Work closely with Global 24 Claims Analyst Singapore/Manila to ensure that all aspects of the claim is accurate, complete and clean and processed in a timely manner following the policy and Program Integrity guidelines.
• Ensure that all aspects of the claims process are in alignment with the Program Integrity standards of this program; ensuring that claims are processed in an ethical manner following Program Integrity guidelines.
• Act professionally in all interactions with the service providers, including both written and telephonic interaction.
• Work closely with the Global 24 Customer Service team Singapore, informing them of any issues that may impact the ability or willingness of Host Nation Providers to accept beneficiaries under The PPN set up.
• Attend provider events and provider meetings as required.

Skills and Knowledge Required:

• Evidence of broad clinical knowledge and in-depth knowledge of the Preferred Provider Network Philippines.
• High level of attention to details
• High level of comfort working with and creating spreadsheets
• Ability to educate others on effective claims processing.
• Ability to work independently on claim forms.
• High level of competency in analyzing data
• Customer service oriented
• Ability to communicate effectively both within the International SOS organization and with external contacts.
• Team player
• Ability to meet objectives and targets.
• Demonstrate appropriate listening skills.
• Demonstrate appropriate spelling and grammar.
• Successful completion of security clearance
• Conducts oneself with ethically and morally high values, ensuring that the company assets, resources, and finances are being managed appropriately.

Required Work Experience:

• Experience with working with medical claims and billing documents.
• Experience with international health care claims management (desirable)
• Educational background in Nursing or other medical related field (desirable)

Education:

• Graduate of any Medical Allied Course.

Travel Requirements:

• This position may require domestic travel up to 90% of the time.