Claims Processor - NurseMarine Benefits, Inc.

Description
- Adjudicates claims based on account coverage, effectivity and benefit plan in compliance to company's policies, claims rules and procedures;
- Reviews and organizes incoming reimbursement claims from foreign countries;
- Analyzing the claim cases for the detection of fraud claimants;
- Responds to members inquiries regarding the company's cost containment program, utilization review decisions and reductions thru emails and phone calls;
- Verifies if the account has adequate funds to cover claim reimbursement or before payment to the provider is released;
- Properly operates and maintain the computerized system used in processing claims through timely and accurate recording of claims information;
Requirements
Minimum education level: Bachelor ́s Degree
Years of experience: 1
Language(s): English
Knowledge: Microsoft Excel, Microsoft Outlook, Learning, Customer service, Self-confidence, Decision making, Communication and persuasion, Team building, Initiative, Leadership, Goal-oriented, Customer Support, Teamwork
Availability for travel: No
Availability for change of residence: Yes

Makati, National Capital Region ·  18 September (updated)
Work type
Full Time