Process Analyst
PH-PH-Taguig City
5d ago

Job Description

Relevant work experience

4 to 6 years relevant experience in US Healthcare Benefit Administration Benefit Coding, Administration Validation, Adjudication Setup and Audit


  • Should have strong expertise in Benefit coding and Adjudication setup process
  • Knowledge of insurance guidelines including HMO PPO, Medicare, Medicaid, and other payer requirements and systems.
  • Competent use of computer systems, software
  • Familiarity with Scrubbing, Sales force, WPD system, JIRA, CMA tools
  • Knowledge on Lincors Testing claims
  • Strong knowledge in Claim Edits clearance and Testing
  • Knowledge of medical terminology likely to be encountered in medical claims.
  • Maintain patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 HIPAA
  • Qualifications

  • College Graduate- MS Excel
  • Good Communication skills (oral and writing)
  • Should be able to take training if required
  • Good Data Analytical skill
  • Optimistic attitude
  • Strong team player attitude- Amenable to work nightshifts
  • Apply
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