Claim Reconciliation Processor

Job Objective / Purpose

The Claim Reconciliation Processor is responsible for processing the account reconciliation requests from the accredited Flexicare network. S/He plays an important role in ensuring that all reconciliations assigned are completed accurately and on time.

This role will be hired under Flexicare HMO under Health Delivery System, Inc. (HDSI) - a subsidiary of RelianceUnited.

• Duties and Responsibilities:

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

• Work Location:

Location: Greenfield District, Mandaluyong City

• Work Schedule: 8:00AM - 5:00PM; Hybrid (subject to change with management notice)

First month will be 100% Work Onsite

• Visit the RelianceUnited Website here:

https://tinyurl.com/ysjsn7ps

• Apply for other roles via RelianceUnited Careers:

https://tinyurl.com/446sye6j

Job Type: Full-time

Pay: From Php18,

• 00 per month
  
  Benefits:
• Free parking

Health insurance

• On-site parking

Opportunities for promotion

• Staff meals provided

Work from home
Schedule:

• 8 hour shift

Day shift
Supplemental pay types:

• 13th month salary

Overtime pay

• Performance bonus

Yearly bonus

Ability to commute/relocate:

• Mandaluyong City: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• How much is you MINIMUM EXPECTED SALARY for this role

Experience:

Medical Claims: 1 year (Preferred)