Claims Inspection Representative

Thornton Tomasetti; Taguig; On-site; PHP 600,000 - 900,000; Full time

Job summary

Abbott in the Philippines seeks a detail-oriented professional to review healthcare claims, ensure accuracy, and maintain patient data across systems. You will resolve discrepancies and coordinate with internal teams to uphold policy and payer guidelines.

Night shifts are required, with a standard workstation setting and access to essential software. The role emphasizes collaboration, precise data handling, and proactive communication to support revenue cycle activities and HR-related tasks

Qualifications

• College diploma or equivalent; higher education in management or healthcare preferred.
• 2+ years in healthcare accounts (Revenue Cycle Management experience preferred).
• 1–2 years data processing experience preferred.
• 1–2 years customer service or provider relations experience preferred.
• Proficiency with technology including computers, software applications, and phone systems.

Responsibilities

• Review submitted claims using a standardized checklist for accuracy and compliance.
• Identify discrepancies and non-compliance issues (Failpoints) and communicate to internal departments for corrective action.
• Maintain accurate patient information in relevant data management systems.
• Respond to inquiries from insurance companies, patients and internal departments.
• Perform other related duties as assigned.

Skills

Interpersonal skills

Communication

Time management

Technical skills

Excel/Word/Outlook

Alere data systems

Computer skills

Education

College diploma

Healthcare/management education preferred

Tools

Alere Home Monitoring

Job description

JOB DESCRIPTION

Abbott is a global healthcare leader, creating breakthrough science to improve people's health. We're always looking towards the future, anticipating changes in medical science and technology. Our rapid diagnostics solutions are helping address some of the world's greatest healthcare challenges. Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and family, be your true self and live a full life. You will have access to: Career development with an international company where you can grow the career you dream of. A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists.

What You'll Do

• Conduct thorough reviews of submitted claims by applying a standardized checklist of requirements to ensure accuracy, completeness, and compliance with internal policies and payer guidelines.
• Accurately identify discrepancies, errors, or non-compliance issues referred to as Failpoints during the claims review process. These findings must be clearly documented and promptly communicated to the appropriate internal departments to initiate necessary corrective actions and ensure process integrity.
• Maintains accurate patient information in relevant Acelis Connected Health data management systems.
• Applies knowledge of company processes and procedures to respond to incoming communication from insurance companies, patients and internal departments.
• Performs other related duties as assigned.

Requirements

• College diploma or equivalent, but more education, especially in management or healthcare, is preferred.
• Minimum of 2 years of experience in healthcare accounts (preferably Revenue Cycle Management work experience).
• One to two years data processing experience preferred.
• One to two years customer service or provider relations experience preferred.
• Proficiency with technology, especially computers, software applications, and phone systems.
• Good verbal and written communication skills.
• Strong understanding of company products, policies, and services.

Competencies

• Fostering Teamwork
• Analytical Thinking
• Commitment to Job Deliverables
• Leadership
• Decision Making
• Trustworthiness and Ethics
• Attention to Details
• Problem Solving
• Attention to Communication
• Technical Expertise
• Customer Orientation
• Managing Change
• Adaptability
• Managing Performance
• Stress Management
• Initiative
• Personal Credibility
• Interpersonal Skills
• Flexibility
• Thoroughness
• Self Confidence

Required Skills

• Communication Excellent interpersonal skills
• Detailed & Team Oriented Professional communication & Writing
• Organization/Time Management Skills
• Technical Skills Detail-oriented
• Basic Excel, Word and Outlook experience required.
• Demonstrates proficiency and accuracy using Alere Home Monitoring data management systems which are directly related to the specific job function.
• Strong Computer/Software Skills

Physical Abilities

• Perform some repetitive motion activities.
• Sit for long periods of time.
• Requires close vision and the ability to adjust eye focus often.
• Required to reach with hands and arms.

Work Schedule

Must be able sit at a standard workstation for long period.

Must be able to work with a standard computer and monitor using keyboard.

No lifting required for this position.

Must have the ability to get to work on time and work for the entire assigned shift.

Must be able to work a night shift from minimum 8:00 PM to 8:00 AM Philippine Standard Time.

Location

This position is based in Philippines.

Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life.

Abbott is an Equal Opportunity Employer, committed to employee diversity.

Job Family

JOB FAMILY: Accounts Payable & Receivables, Credit & Collection, & Payroll DIVISION: HF Heart Failure LOCATION: Philippines > Taguig City : Five/Neo Building ADDITIONAL LOCATIONS: WORK SHIFT: Standard TRAVEL: Not specified MEDICAL SURVEILLANCE: Not Applicable SIGNIFICANT WORK ACTIVITIES: Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day) Abbott is about the power of health.

Abbott is about the power of health. For more than 135 years, Abbott has been helping people reach their potential - because better health allows people and communities to achieve more. With a diverse, global network serving customers in more than 160 countries, we create new solutions - across the spectrum of health, around the world, for all stages of life. Whether it's next-generation diagnostics, life-changing devices, science-based nutrition, or novel reformulations, we are advancing some of the most innovative and revolutionary technologies in healthcare, helping people live their best lives through better health. The people of Abbott come to work each day with relentless energy, enthusiasm and a promise to enhance the health and well-being of millions of people. They push the boundaries to help manage and treat some of life's greatest health challenges. We invite you to explore opportunities at Abbott, to see if your talents and career aspirations may fit with our openings. An equal opportunity employer, Abbott welcomes and encourages diversity in our workforce.

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Connect with us at www.abbott.com, on Facebook at www.facebook.com/Abbott and on Twitter @AbbottNews and @AbbottGlobal.

The base pay for this position is N/A In specific locations, the pay range may vary from the range posted.