Medical Claims Adjudicator

Working Arrangement

Hybrid

Job Description

The Opportunity 

The customer is the focus of everything we do, and millions of end users rely on our products daily. We believe in the value of empowering Medical Claims Adjudicators with the resources to solve critical problems for the future of our business, which is why we need you. 

Key Responsibilities:

• Input, analyze, and assess claims submissions from customers

• Evaluate and process claims in accordance to contractual limitations and standard operating procedures, within agreed service level through the aid of published claims manual

• Consistently meet or exceed productivity while meeting quality standards

• Refer a claim for inquiry and clarification when necessary

Minimum Skills Required to Hire:

Qualifications:

• Graduate of any bachelor’s degree course, preferably from a medical or financial course

• Knowledge of/or work experience in the insurance industry

• Knowledge of claims processing

• HYBRID Work Arrangement – amenability and readiness to work onsite and from home anytime (dependent on business needs AND/OR current external environment/situation).

Technical Skills:

• Basic computer and keyboarding skills with a minimum of 30 WPM

Soft Skills:

• Excellent comprehension, analytical, and decision-making skills

• Great in information relay and communication skills

Nice to Haves:  

• Ability to understand medical terminologies in diagnosis and laboratory exams

• Good organization and analytical skills

• Willing to render overtime work as needed

• Flexible and adaptable to change

• Proven ability to balance approach in different levels of transactions

Our commitment to you

• Our mission; to be a part of making Decisions Easier and Lives Better

• A leadership team dedicated to your growth and success

• A bold ambition and set of goals to be a leader in driving transformation in our industry

• Our best. Every day.