HDSI: Claims Processor Analyst
On-site · Mandaluyong, Metro Manila, Philippines
Job Summary
Claims Processor Analyst role focused on timely, accurate processing and adjudication of employee benefit claims for FlexBen and Health Benefit Administration programs. Responsibilities include capturing claim data into the claims management system, analyzing claims for completeness and compliance with plan terms, confirming member eligibility and coverage, adjudicating payments or escalating as needed, investigating discrepancies by coordinating with members and other stakeholders, updating employees on claim progress, and handling inquiries per agreed SLAs.
Required Qualifications
- Bachelor's/College Degree in health/medical allied fields preferred (Nursing, Pharmacy, etc.)
- At least 2 years of experience in related field
- Experience with TPA, HMO, insurance or insurance broker companies
- Ability to work onsite and extend beyond operating hours
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