Claims Supervisor

InLife Benefits Insurance Company, Inc.; Cebu City; On-site; PHP 500,000 - 600,000; Full time

Job summary

InLife Benefits Insurance Company, Inc. is seeking an experienced claims supervisor to oversee medical/life claims processing. The role includes verifying details, conducting updates in MAS, and ensuring timely payments and reconciliations.

You will also perform UAT for system enhancements and address inquiries from providers and callers. The ideal candidate will have a college degree in a medical or business field, at least five years in claims processing, and 2–3 years in a supervisory

Qualifications

• 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 LOma courses.

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 elevate within TAT.
• Reconcile statement of account (SOA) sent by providers and coordinate with concerned departments.

Skills

Claims processing

Attention to detail

Communication

Education

Bachelor's degree in medical or business-related discipline

Job description

Key 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 elevate 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