Claims Executive/Specialist | Asia Pacific Healthcare Account - AVEGA

Industry Category	Healthcare	Position	Practitioner / Medical Asst
Recruitment Department		Number Of Recruits	several
Work Location	All Cities	Nature Of Work	Full Time
Gender Requirements	Male	Marriage Requirement	No marital status restrictions
Education Level	College Diploma	Work Experience	No work experience restrictions
Age Requirement	Above 18 years old	Salary Package	Negotiable
Updated Date	2022-09-28	Valid Until	Long-term validity

Be part of our growing Pioneer Team! Provides administration support for claims processing and perform simple claims assessment.

Earn up to P30,000.00 monthly Salary HMO coverage from day 1 of employment; with dependent/s Dental Benefit Monthly performance incentives 

Requirement

Able to work on-site1 – 2 years relevant experience in Healthcare, Insurance or BPO industryExcellent verbal and written communication skillsProficient in Windows OS, MS Office applications Has a Knowledge in medical and insurance terminologiesHas critical thinking skills with a focus on issue resolution and customer satisfaction Can multitask and has high attention to details Is self-motivated, can work independently, and contribute to cross-functionalIs flexible and can quickly adjust to frequent process and information changes Can work under pressure 

Tasks

Adjudicate claimsInitiating or conducting investigations of questionable claims.Resolves claims by approving or denying, calculating benefit due, initiating payment, preparing notice to member after case adjudication by indicating remarks in the system.documentation of medical claims by preparing worksheets for inpatient cases, data entry in the system, reports, logs and records.Maintains quality services by following client service practices and responding to customer enquiries.Performs second layer checking of claims proposed by junior assessorsHandles specific portfolio with specific service agreement

Qualifications

Bachelor’s degreeBachelor's degree in medical-related field is an advantage

AVEGA MANAGED CARE, INC. is a managed care company that is committed to revolutionize a new vision for healthcare administration. It was incorporated in April 2011 and launched in July 2011 as a direct response to the growing need for innovative healthcare solutions. AVEGA provides client-companies with options on how to manage their health plans in relation to the growth of their business. AVEGA enters the market with a wealth of experience in managed care rooted in service excellence – top quality, consistent, and highly-personalized services that go beyond the usual norm of patient care. AVEGA’s countrywide infrastructure assures comprehensive and accessible medical care for members through its network of medical providers.  Nearly 1,300 reputable hospitals, clinics, diagnostic centers, and other first-class medical institutions make up the AVEGA network, operated by a pool of almost 15,000 of the country’s most regarded physicians and medical specialists. Across the Philippines, AVEGA delivers seamlessly-coordinated medical care, in-hospital management, efficient clinic operations, quality control processes, and credibility among the expansive network of its providers. A 24/7 call center and on-site Patient Relations Officers in each accredited tertiary hospital ensure client-companies of high-tech and high-touch service at all times.  Operations for AVEGA services are executed by a dynamic and professional workforce. The board of healthcare management experts and respected medical practitioners uphold the company’s commitment to deliver all services with a deep sense of humanity and compassion, founded on integrity, transparency, accountability, and respect for life – the cornerstones of our corporate values.