Marine Benefits, Inc. Medical Claims Analyst

₱20-25K[Monthly]

Hybrid - MakatiFull-time1-3 Yrs ExpBachelor

Registered Nurse is an advantageEnglish proficientCustomer serviceTeam playerStrong work ethicInterpersonal skillsBack office support

Assure accurate insurance claims adjudication in a timely manner.
Assure timely submission of invoices/claims utilization report.
Validate documents received as well as members' information to adjudicate the Claims based on the submitted information.
Apply the Plan policy and its exclusion as well as underwriting guidelines to determine coverage for claims.
Deny claims according to SOB, exclusions and policies.
Assure timely payment of invoices from providers and ensure all information and documents needed are accurate and complete.
Keep management aware of members' issues from providers to enhance operations and escalate to the higher-ups when necessary.
Coordinate with providers all Claims unpaid and do reconciliation.
Answer inquiries and handle complaints from providers.

Bachelor's degree in nursing or related course.
Registered Nurse is an advantage.
Thorough knowledge of the claims process in medical insurance with a minimum 1 year of relevant experience.
Structured and organized.
Good oral and written English communication skills.

Doris Dalisay

HR ManagerMarine Benefits, Inc.

Active this week

29/F, 29/F, Pacific Star Bldg, Makati Avenue, 1226 Sen. Gil J. Puyat Ave, Makati, Metro Manila, Philippines

Allowances
Telecommunication Allowance, Meal Allowance
Government Mandated Benefits
13th Month Pay, Pag-Ibig Fund, Paid Holidays, Philhealth, SSS/GSIS
Insurance Health & Wellness
HMO
Others
Profit Sharing
Perks Benefits
Free Meals, Retirement Plan
Time Off & Leave
Maternity & Paternity Leave, Parental Leave, Sick Leave, Solo Parent Leave, Special Leave for Women, Vacation Leave
Work-Life Balance
Flexible Hours, Work from Home