Analyze claims as appropriate for e.g. pay, pend or deny.
Adjudicate claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.
Monitor turnaround times to ensure claims are settled within required time scales, highlighting when this is not achievable.
Monitor and highlight high cost claims and ensure relevant parties are aware.
Interface effectively with internal and external customers to resolve customer issues.
Actively support all team members and provide resource to enable all operational goals to be achieved
Meet or exceed Service level agreement requirements. Minimally set at a 7 day turnaround for claims or in accordance with client specific requirements. This number will be reviewed periodically and can be increased or decreased based on business need.
Good understanding of international healthcare product and plan design.
Hiring criteria
You should have or be completing the following to apply for this opportunity.
Entry pathway
Degree or Certificate
Minimum Level of Study
Bachelor or higher
Study Field
B
Accounting
Commerce
Finance
Actuarial Studies
Business
Business Administration
Event Management
International Business
Management
Office Studies
Economics
Human Resources
Hospitality Management
Retail & Merchandising
Tourism
C
Communication
Media Studies
Creative Arts (all other)
Fashion Design
Film & TV
Fine Arts
Graphic Design & Visual Arts
E
Aerospace Engineering
Air Traffic Control
Aircraft Maintenance Engineering
Aircraft Operation & Aviation
Automotive & Transport Engineering
Biomedical Engineering
Chemical Engineering
Civil Engineering & Construction
Communications Engineering
F
Baking and Pastry-making
Butchery
Cookery
Food & Hospitality (all other)
Food and Beverage Service
Food Hygiene
Beauty Therapy
Hairdressing
Personal Services (all other)
H
Anthropology
Geography
Archaeology
History
Classics
Criminology
Gender Studies
Indigenous Studies
International Development
Peace & Conflict
Refugees & Forced Migration
Humanities (all other)
I
Artificial Intelligence
Bioinformatics
Computer Graphics & Animation
Computer Science (all other)
Computer Systems and Networks
Cyber Security
Work rights
The opportunity is available to applicants in any of the following categories.
country
eligibility
Philippines
Philippine Citizen
Philippine Permanent Resident
Graduate Success Stories
Graduate stories
Accenture emphasizes work-life balance for their employees, unlike the usual 9-to-5, we aren’t expected to report onsite every day. And in fact, I usually go to the office only about once a month.