Claims Supervisor

InLife Benefits PH; Cebu City; Presencial; PHP 420.000 - 660.000; Jornada completa

Descripción de la vacante

InLife Benefits PH in Cebu City is seeking an experienced Claims Supervisor to review and process medical claims in line with company policies. The role requires coordinating with providers and internal teams to ensure accurate reconciliations and timely payments.

The ideal candidate holds a Bachelor's degree in a medical, healthcare, or business field with at least 3 years in medical claims supervision; LOma certification is an advantage.

Formación

• Bachelor's degree in a medical, healthcare, or business-related field.
• Minimum 3 years of medical claims in a supervisory role.
• LOMA certification or coursework is an advantage.

Responsabilidades

• Review and process medical claims in accordance with company policies and guidelines.
• Verify claim accuracy, reconcile provider accounts, and prepare payment transmittals.
• Approve claims within authority limits and escalate when necessary.
• Handle inquiries, disputes, and payment concerns within prescribed turnaround times.
• Coordinate with providers and internal teams on claims reconciliation and SOA validation.
• Support system enhancements through UAT testing and process improvement initiatives.

Conocimientos

Claims supervision

Healthcare domain knowledge

Process improvement

Educación

Bachelor's degree in a medical, healthcare, or business-related field

Descripción del empleo

• Review and process medical claims in accordance with company policies and guidelines.
• Verify claim accuracy, reconcile provider accounts, and prepare payment transmittals.
• Approve claims within authority limits and escalate when necessary.
• Handle inquiries, disputes, and payment concerns within prescribed turnaround times.
• Coordinate with providers and internal teams on claims reconciliation and SOA validation.
• Support system enhancements through UAT testing and process improvement initiatives.

REQUIREMENTS

• Bachelor's degree in a medical, healthcare, or business-related field.
• Minimum 3 years of medical claims in a supervisory role.
• LOMA certification or coursework is an advantage.