Claims Supervisor

InLife Benefits PH; Cebu City; On-site; PHP 420,000 - 540,000; Full time

Job summary

InLife Benefits PH is seeking a claims processing supervisor in Cebu City to oversee medical/life claims handling. You will validate claim details, coordinate with billers and the Call Center, and ensure payments align with policy guidelines and authority limits.

The role requires 5+ years in claims processing, 2-3 years supervisory experience, and LOOMA course familiarity is preferred. Join a team focused on accuracy, timely resolutions, and process improvements.

Qualifications

• 5+ years' experience in medical or life claims processing.
• 2-3 years' supervisory experience.
• LOMA courses preferred.

Responsibilities

• Check availability and accuracy of claims details in MAS and make necessary corrections.
• Verify unlisted claims in MAS with biller and Call Center.
• Process and analyze claims using prescribed process and based on existing policy contract and guidelines.
• Prepare transmittal of claims for payment.
• Approve payment for claims within authority limit and recommend approval of claims payment beyond authority limit.
• Reconcile claims with providers and accounts.
• Conduct UAT of system enhancements and provide analysis and findings.
• Answer inquiries via email or phone regarding status of claims or overdue payments within set turn-around time.
• Document medical claims disputes or complaints and resolve or escalation within TAT.
• Reconcile statement of account (SOA) sent by providers and coordinate with concerned departments.

Skills

Claims processing

Customer service

Education

Bachelor's degree in medical or business discipline

Job description

• Check availability and accuracy of claims details in MAS and make necessary corrections
• Verify unlisted claims in MAS with biller and Call Center
• Process and analyze claims using prescribed process and based on existing policy contract and guidelines
• Prepare transmittal of claims for payment
• Approve payment for claims within authority limit and recommend approval of claims payment beyond authority limit
• Reconcile claims with providers and accounts
• Conduct UAT of system enhancements and provide analysis and findings
• Answer inquiries via email or phone regarding status of claims or overdue payments within set turn-around time
• Document medical claims disputes or complaints and resolve or escalation within TAT
• Reconcile statement of account (SOA) sent by providers and coordinate with concerned departments

About you

• College graduate with a degree in any medical or business-related discipline
• At least 5 years' experience in medical or life claims processing
• At least 2 - 3 years' experience at supervisory level
• Preferably passed Life Office Management Association (LOMA) courses