Job Objective / Purpose
The Claim Documentation Analyst reviews claim documents for the completeness and accuracy of information. S/he prepares claim documents for sending to the Accounting department within the agreed TAT.
An important part of the role is to ensure full maintenance of storage of received/ processed claims.
This role will be hired under Flexicare HMO under Health Delivery System, Inc. (HDSI) - a subsidiary of RelianceUnited.
Duties and Responsibilities:
Registers and checks for the completeness and accuracy of received claim documents.
Scans, sorts and assigns good claims to claim processors. Informs provider network of the claim denial and sends back received documents.
Sends Medical Collectible Letters to members with disapproved charges.
Forwards complete and correct claim documents to the Accounting team within the agreed TAT from processing date.
Extend support to Claim Adjudicators / Recon Analyst as needed.
Background and Qualifications:
A Bachelor’s Degree in business or any related degree
At least 1 year of solid working experience in the related field is required for this position
Familiar with health insurance / HMO policies and coverages, preferred.
A candidate possessing strong attention to detail.
Good communication (written and oral) and interpersonal skills.
Exceptional critical thinking skills and is able to investigate root causes and recommend solutions.
Strong organizational, multi-tasking and time-management skills.
Work Location:
Greenfield District, Mandaluyong City: Reliably commute or planning to relocate before starting work (Required)
Visit the RelianceUnited Website here:
https://tinyurl.com/ysjsn7ps
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