Claims Processor for Healthcare Benefits/16k/Angeles Pampanga
Angeles, Pampanga, Pampanga
Posted 3 days ago
- Company:
- Dempsey Inc
- Company Description:
- Is a company authorized to engage in the local manpower placement. It is duly registered with the Department of Labor and Employment, Securities and Exchange Commission, Bureau of Internal Revenue with the corresponding Quezon City business permit. There is no other company registered with exactly the same with our trade name and address. Clearly, anyone who represents and uses our trade name Dempsey Resource Management Inc. is deemed fake and a scammer with ill intent purpose
- Contract Type:
- Full Time
- Experience Required:
- 1 year
- Education Level:
- Bachelor’s Degree
- Number of vacancies:
- 1
Job Description
Work Schedule: Mon-Fri 8:30am-5:30pm
Salary Offer: 16, 000
Responsibilities:
➢ Review and analyze healthcare claims for accuracy, completeness, and adherence to contractual agreements and regulatory guidelines.
➢ Verify member eligibility and benefits coverage for submitted claims.
➢ Evaluate medical documentation to assess the appropriateness of services rendered and coding accuracy.
➢ Adjudicate claims accurately and efficiently within established turnaround times.
➢ Identify and investigate potential fraudulent or abusive billing practices.
➢ Communicate claim decisions, payment details, and denials to providers and members effectively.
➢ Collaborate with other departments, such as Provider Relations and Customer Service, to resolve claim-related issues and inquiries.
➢ Maintain comprehensive and organized claim records, documentation.
- Salary:
- 16.000,00 ₱ Monthly