Medical Claims Processor | Pharmacist/Nurse

dnata Travel Inc.; Mabalacat; On-site; PHP 279,000 - 446,000; Full time

Job summary

dnata Travel Inc. in Clark, Pampanga is looking for a Medical Claims Processor to handle e-claims from external medical providers and ensure accurate adjudication within policy and SLA; support batch reconciliation and reporting.

Applicants must hold a Bachelor’s degree in Nursing, Midwifery, or Pharmacy, with RN/Midwife/Dental Nurse/Pharmacist licensure and at least two years of hospital experience. Willingness to relocate to Clark is essential.

Qualifications

• Bachelor’s degree in nursing, midwifery, or pharmacy.
• Willing to work and relocate to Clark, Pampanga.
• Minimum 2 years hospital experience as Staff Midwife, Staff Nurse, Dental Nurse or Pharmacist.
• Registered Nurse, Midwife, Dental Nurse or Pharmacist license/certification.

Responsibilities

• Process e-claims from external medical service providers.
• Adjudicate claims accurately per policy terms and SLA.
• Review medical costs, service line items, and medical codes for appropriateness.
• Escalate claims per SOP and reconcile batches.
• Support team leader with claims reporting, analyses, and onboarding new joiners.

Skills

Willing to relocate

Professional licensure requirement

Education

Bachelor's Degree in Nursing, Midwifery or Pharmacy

Job description

dnata Travel Inc. in Clark, Pampanga is looking for a Medical Claims Processor to handle e-claims from external medical providers and ensure accurate adjudication within policy and SLA; support batch reconciliation and reporting.

Applicants must hold a Bachelor’s degree in Nursing, Midwifery, or Pharmacy, with RN/Midwife/Dental Nurse/Pharmacist licensure and at least two years of hospital experience. Willingness to relocate to Clark is essential.