Medical Claims Specialist — Accuracy & Compliance

Eastwest Healthcare Inc,.; Philippines; On-site; PHP 201,000 - 268,000; Full time

Job summary

Eastwest Healthcare Inc., Philippines, is seeking a Claims Processor to handle medical claims with accuracy and timely turnaround. You will encode claims and update records, ensuring alignment with policies and medical guidelines.

You will collaborate with internal teams to resolve claim concerns, escalate discrepancies when needed, and participate in trainings aimed at process improvements and quality enhancement.

Responsibilities

• Process medical claims accurately and within the required turnaround time
• Meet daily productivity and quality targets
• Ensure claims comply with policies, benefits, and medical guidelines
• Encode claims and update records in the system
• Coordinate with internal teams to resolve claim concerns
• Escalate discrepancies and incomplete documentation when necessary
• Support process improvements and participate in relevant trainings

Job description

Eastwest Healthcare Inc., Philippines, is seeking a Claims Processor to handle medical claims with accuracy and timely turnaround. You will encode claims and update records, ensuring alignment with policies and medical guidelines.

You will collaborate with internal teams to resolve claim concerns, escalate discrepancies when needed, and participate in trainings aimed at process improvements and quality enhancement.