Senior Medical Claims Operations Lead

InLife Benefits PH; Cebu City; On-site; PHP 600,000 - 900,000; Full time

Job summary

InLife Benefits PH in Cebu City is seeking a Senior Medical Claims Supervisor to review and process medical claims in line with company policies. You will validate claims, reconcile provider accounts, and prepare payment transmittals in a timely, accurate manner.

The role requires at least 3 years in a supervisory claims position, a relevant degree, and potential advantage from LO MA coursework. This on-site role emphasizes compliance and continuous process improvements within the claims team.

Qualifications

• Bachelor’s degree in a medical, healthcare, or business-related field.
• Minimum 3 years of medical claims in a supervisory role.
• LOMA certification or coursework is an advantage.

Responsibilities

• Review and process medical claims in accordance with company policies and guidelines.
• Verify claim accuracy, reconcile provider accounts, and prepare payment transmittals.
• Approve claims within authority limits and elevate when necessary.
• Handle inquiries, disputes, and payment concerns within prescribed turnaround times.
• Coordinate with providers and internal teams on claims reconciliation and SOA validation.
• Support system enhancements through UAT testing and process improvement initiatives.

Skills

Supervisory experience

Medical claims processing

Education

Bachelor's degree in medical/healthcare or business field

Job description

InLife Benefits PH in Cebu City is seeking a Senior Medical Claims Supervisor to review and process medical claims in line with company policies. You will validate claims, reconcile provider accounts, and prepare payment transmittals in a timely, accurate manner.

The role requires at least 3 years in a supervisory claims position, a relevant degree, and potential advantage from LO MA coursework. This on-site role emphasizes compliance and continuous process improvements within the claims team.