Nurse Claims Processor - Adjudication & Analysis (Clark)

dnata Travel Group; Philippines; On-site; PHP 335,000 - 614,000; Full time

Job summary

dnata Travel Group in Clark, Pampanga seeks a Registered Nurse to join our medical claims team. The role focuses on processing e-claims from external providers, ensuring accurate adjudication and cost review.

Applicants must have a Bachelor's in Nursing, be a licensed RN, and have at least 2 years hospital experience (Staff Nurse, Midwife or Dental Nurse). On-site role requiring relocation to Clark, Philippines.

Qualifications

• Bachelor's degree in Nursing required.
• Registered Nurse with valid license.

Responsibilities

• Process e-claims from external medical providers.
• Adjudicate claims accurately per policy and SOP.
• Review medical costs and service line items.
• Review medical codes and supporting documents to determine appropriateness.
• Escalate claims per SOP and ensure batch reconciliation.

Skills

Claims processing

Adjudication

Medical cost review

Medical coding review

SOP compliance

Education

Bachelor's Degree in Nursing

Job description

dnata Travel Group in Clark, Pampanga seeks a Registered Nurse to join our medical claims team. The role focuses on processing e-claims from external providers, ensuring accurate adjudication and cost review.

Applicants must have a Bachelor's in Nursing, be a licensed RN, and have at least 2 years hospital experience (Staff Nurse, Midwife or Dental Nurse). On-site role requiring relocation to Clark, Philippines.