Senior Medical Claims Supervisor

InLife Benefits PH; Cebu City; On-site; PHP 420,000 - 540,000; Full time

Job summary

InLife Benefits PH is seeking a claims processing supervisor in Cebu City to oversee medical/life claims handling. You will validate claim details, coordinate with billers and the Call Center, and ensure payments align with policy guidelines and authority limits.

The role requires 5+ years in claims processing, 2-3 years supervisory experience, and LOOMA course familiarity is preferred. Join a team focused on accuracy, timely resolutions, and process improvements.

Qualifications

• 5+ years' experience in medical or life claims processing.
• 2-3 years' supervisory experience.
• LOMA courses preferred.

Responsibilities

• Check availability and accuracy of claims details in MAS and make necessary corrections.
• Verify unlisted claims in MAS with biller and Call Center.
• Process and analyze claims using prescribed process and based on existing policy contract and guidelines.
• Prepare transmittal of claims for payment.
• Approve payment for claims within authority limit and recommend approval of claims payment beyond authority limit.
• Reconcile claims with providers and accounts.
• Conduct UAT of system enhancements and provide analysis and findings.
• Answer inquiries via email or phone regarding status of claims or overdue payments within set turn-around time.
• Document medical claims disputes or complaints and resolve or escalation within TAT.
• Reconcile statement of account (SOA) sent by providers and coordinate with concerned departments.

Skills

Claims processing

Customer service

Education

Bachelor's degree in medical or business discipline

Job description

InLife Benefits PH is seeking a claims processing supervisor in Cebu City to oversee medical/life claims handling. You will validate claim details, coordinate with billers and the Call Center, and ensure payments align with policy guidelines and authority limits.

The role requires 5+ years in claims processing, 2-3 years supervisory experience, and LOOMA course familiarity is preferred. Join a team focused on accuracy, timely resolutions, and process improvements.