Medical Claims Analyst
YOUR ROLE
- Verification of cover in order to determine if indeed there is coverage/policy in-force when the loss occurs
- Makes the necessary recommendation on a claim (such as for final action or to require further documents or information) or makes a final decision on claim, in accordance with the claim's authority
- Handles the necessary communication that should be provided to claimants
- Ensures proper documentation of cases evaluated
- Handles inquiries of the status of a claim
- Provides claimants with appropriate and prompt explanation of claims benefits which may not be payable or limited
- Assesses additional or new information on a denied claim or a claim with limited benefits payout and determine if there are grounds for consideration or a revised recommendation
- Maintains the confidentiality of claims records
- Should at all times meet the department's standards for quality and turnaround time
- Deals with third-party administrations (TPAs), adjusters and other service providers
- Performs other duties as necessary in meeting the objectives/mission of the department or as assigned by superior
A BIT ABOUT YOU
- Graduate of a bachelor's degree course (preferably with medical background)
- At least 3 years' work experience in similar capacity
- Proficient in Microsoft office
Employer questions
- What's your expected monthly basic salary?
- Which of the following types of qualifications do you have?
- How many years' experience do you have as a Medical Claims Analyst?
Company profile
Be part of the team with a Heart to Serve!
For over 60 years, Pioneer has been dedicated to wholeheartedly serving Filipinos through insurance. As an all-Filipino insurance company, we put our Heart to Serve at work through our relevant and innovative non-life and life coverages, and efficient and fair claims settlement process to help our clients protect what matters most to them, so they can financially prepare for and move on from personal tragedies. Whether it’s securing ma’am or manang, your café and your crew, or your staff and your stuff – Pioneer has got them covered.
Pioneer has been named by Euromoney Annual Insurance Survey as the Best Insurance Company in the Philippines for two consecutive years, beginning 2009. In 2010, it was likewise recognized as Best Insurer in Asia. In 2012, Pioneer was recognized by the Insurance Commission for its significant contributions to the field of microinsurance.
We are driven by our core values of integrity, excellence, and malasakit, as embraced by our more than 1000 employees working in our more than 30 branches nationwide.
If you have a heart that beats for Filipinos and making a difference in their lives, then get in touch with us today and start your career at Pioneer!
To learn more, please visit our company website - http://www.pioneer.com.ph/
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