Nurse - Medical Benefits

Recruiting Specialist at Dnata Travel Inc.

Job Title: Medical Claims Processor

Eligibility / Qualifications

• Applicants must be willing to work and relocate to Clark, Pampanga.
• Applicants must be a Filipino citizen or have a relevant residence status.
• Have a Bachelor's Degree in Nursing or Midwifery.
• Registered Nurse / Midwife / Dental Nurse.
• Minimum of 2 years hospital experience as Staff Midwife, Staff Nurse or Dental Nurse.

Key Responsibilities and Accountabilities

• The primary task is to process e-claims received from external medical service providers, including:
  • Accurate claims adjudication as per policy terms and conditions.
  • Accurate claims adjudication as per agreed business SOP and within agreed SLA’s.
  • Review and evaluation of medical costs and service line items.
  • Review and evaluation of medical codes, supporting document...