Health Claims Officer

As a Health Claims Liaison Officer, you will be assigned to hospitals across the country, providing support to health clients in Metro Manila, Metro Cebu, and Davao. Your primary role is to manage client relations and ensure seamless healthcare access for hospitalized members.

Key Responsibilities:
Engage with hospitalized members, ensuring their needs are met while providing clear communication on health insurance benefits.
Coordinate between patients and providers (doctors, hospitals, clinics) for smooth healthcare service delivery.
Build and maintain strong relationships with Third-Party Administrators (TPAs) and healthcare providers. Ensure agreements are properly documented.
Oversee LOs and ensure effective coordination between TPAs and providers. Escalate issues when necessary.
Liaise with hospital billing departments and head office for client coverage verification. Gather medical documents for claims assessment.

Qualifications:
Minimum of 5 years in an HMO or health insurance company; and At least 3 years on a Liaison Officer role.
Working experience/knowledge of health general practice
With Pleasing personality and currently residing in any of the following areas: Metro Manila, Metro Cebu & Davao.
Okay to travel between locations.
Excellent interpersonal skills including advanced communication skills, both written and verbal.
Good presentation skills and ability to speak publicly.
Good networking skills and confidence in liaising and building strong relationships with stakeholders at all levels internal and external to the organization.