Taguig City, PHL
20 hours ago
Claims Inspection Representative
**POSITION SUMMARY** The Claims Inspection Representative is responsible for handling claims review through an established checklist to ensure accurate claim requirements are met before it is released to the insurance. **JOB RESPONSIBILITIES:** + Conduct thorough reviews of submitted claims by applying a standardized checklist of requirements to ensure accuracy, completeness, and compliance with internal policies and payer guidelines. + Accurately identify discrepancies, errors, or non-compliance issues—referred to as _Failpoints_ —during the claims review process. These findings must be clearly documented and promptly communicated to the appropriate internal departments to initiate necessary corrective actions and ensure process integrity. + Maintains accurate patient information in relevant Acelis Connected Health data management systems. + Applies knowledge of company processes and procedures to respond to incoming communication from insurance companies, patients and internal departments. + Performs other related duties as assigned. **MINIMUM REQUIREMENTS:** + College diploma or equivalent, but more education, especially in management or healthcare, is preferred. + Minimum of 2 years of experience in healthcare accounts (preferably Revenue Cycle Management work experience). + One to two years data processing experience preferred, + One to two years customer service or provider relations experience preferred + Proficiency with technology, especially computers, software applications, and phone systems. + Good verbal and written communication skills. + Strong understanding of company products, policies, and services. **COMPETENCIES** + Fostering Teamwork + Commitment to Job Deliverables + Decision making + Attention to Details + Attention to Communication + Customer Orientation + Analytical Thinking + Leadership + Trustworthiness and Ethics + Problem Solving + Technical Expertise + Managing Change + Managing Performance + Adaptability + Initiative + Interpersonal Skills + Thoroughness + Self Confidence + Stress Management + Personal Credibility + Flexibility **COMMUNICATION SKILLS** + Excellent interpersonal skills + Detailed & Team Oriented + Professional communication & Writing Organization/Time Management Skills **TECHNICAL SKILLS** + Detail-oriented + Basic Excel, Word and Outlook experience required. + Demonstrates proficiency and accuracy using Alere Home Monitoring data management systems which are directly related to the specific job function. + Strong Computer/Software Skills **PHYSICAL ABILITIES** + Must be able sit at a standard workstation for long periods + Must be able to work with a standard computer and monitor using keyboard + No lifting required for this position + Must have the ability to get to work on time and work for the entire assigned shift + Must be able to work a night shift from minimum 8:00 pm to 8:00 am Philippine Standard Time. An Equal Opportunity Employer Abbot welcomes and encourages diversity in our workforce. We provide reasonable accommodation to qualified individuals with disabilities. To request accommodation, please call 224-667-4913 or email corpjat@abbott.com
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