HDSI: Claim Reconciliation Processor (Health Claims)

• Conducts reconciliation of claims records from accredited hospitals and doctors within the agreed TAT to avoid suspensions of service.
• Research variances and closely coordinate reconciliation issues with other claims team ( eg. claim adjudicator, documentation) ,  Provider Relations team and/or Accounting team to resolve issues.
• Maintains logs used by the Recon team.
• Serve as a subject matter expert on claims reconciliation processes and procedures, providing guidance and support to colleagues as needed.
• Escalates issues / concerns on reconciliation process / requests to relevant departments.
  
  

Background and Qualifications:

• Candidates must possess at least a Bachelor's/College Degree in any field.
• Prior experience in claim reconciliation within the HMO or insurance industry is preferred.
• Ability to do on-site visits and extend beyond company operating hours when needed.
• Good communication and critical thinking skills.
• Knowledgeable of Google platforms such as but not limited to GDocs, GSheets, etc. and MS Office.
• Ability to handle multiple tasks, in a timely manner, on a continual basis under strict deadlines.
• Strong planning, organization, and follow-up skills.
• Proven ability to work independently and as a team member
• Adheres consistently to the company values

• Onsite work set up
• Work Schedule: Mondays-Fridays, 8:00AM - 5:00PM
• Assigned in Greenfield District, Mandaluyong City
• Occasional travel to build partnerships with institutions and organizations may be expected, as well as attendance at relevant conferences and events