Intake Process Associate - Claims

Principal Global Services (Philippines) LLC; Taguig; On-site; PHP 180,000 - 240,000; Full time

Job summary

Principal Global Services (Philippines) LLC is seeking a detail-oriented claims processor to evaluate information and determine if a claim progresses to IGO or follows the NIGO process with a formal determination.

In this role, you will communicate with claimants, employers, beneficiaries, and medical providers; document all interactions, maintain accurate files, and ensure monthly quality targets are met. You will also contribute to workflow improvements and mentor team members.

Qualifications

• Must have a high school diploma or GED or 1-2 years related work experience.
• Ability to maintain a high degree of accuracy while being detail oriented.
• Must be able to work in a team environment.
• Strong analytical, organizational, problem solving and decision-making skills.
• Ability to maintain confidentiality.
• Strong verbal and written communication with diverse stakeholders.
• Ability to maintain good public relations with customers (employers, employees, and beneficiaries).

Responsibilities

• Analyze and process information to decide if a claim moves to IGO or follows the NIGO process with determinations.
• Communicate with claimants, employers, beneficiaries, and medical providers; document and maintain claim files.
• Initiate ideas to improve team efficiency and workflows.
• Provide training and coaching for the NIGO/IGO team as a resource.
• Organize, set priorities, and manage caseload to meet all requirements and assist others.

Skills

Attention to detail

Team player

Analytical skills

Communication skills

Confidentiality

Public relations

Education

High school diploma or GED

Job description

What You\'ll Do

Description of Time Spent

• Analyze and process information received/not received to decide if claim moves to IGO or if claim follows our NIGO process where a determination is made on the claim. 25%


• Communicate, both written and verbally with claimants, employers, beneficiaries, and medical providers regarding claim status and to obtain/collect information to assist with the claim process. Fully document claim and maintain claim file for all communication. Maintain accurate monthly requirements/quality. 30%


• Initiate ways to improve the team and work efficiency. 10%


• Provide training/coaching and act as a resource for the NIGO/IGO team. 10%


• Organize, set priorities, and effectively manage caseload to ensure all requirements are met. May assist others in establishing their workload priorities. 25%

Who You Are

Qualifications

• High school diploma or GED required, or 1-2 years related work experience


• Ability to maintain a high degree of accuracy while being detail oriented required


• Must be able to work in a team environment


• Good analytical, organizational, problem solving and decision-making skills


• Ability to maintain confidentiality


• Strong verbal and written communication skills (must be able to communicate with individuals experiencing illnesses, financial losses, or deaths of loved ones as well as legal and/or medical professionals)


• Ability to maintain good public relations with customers (employers, employees, and beneficiaries