Sourcing and Attracting Talent
Lennor Metier Consulting, a leading Recruitment Agency & Headhunters in the Philippines, is urgently recruiting an Claims Associate (Healthcare).
Industry: Financial Services
Salary Range: Open
Work Setup: Onsite during training period with possibility of working hybrid after
Shift Schedule: Night Shift
Location: Taguig City
Job Overview
The Claims Associate plays a critical role in managing the end-to-end claims process, from initial intake to resolution, ensuring a seamless experience for clients. This role requires a proactive approach to meet weekly targets, maintain accuracy in documentation, and provide excellent customer service.
Your Responsibilities:

• Consistently meet weekly pull targets to fulfill demand requirements.
• Process accidental claims to completion, following the 10-day letter protocol as needed.
• Address new information and pending tasks within 2 days, and all other tasks within 3 days.
• Complete tasks thoroughly without advancing them until all required actions are finished.
• Maintain detailed and timely claim notes, conduct phone interviews, and upload all claim-related documents and guidelines.
• Act on guidance from your leader or technical partners, incorporating feedback from 1-on-1 meetings, Quality Reviews, Pend Reviews, and RN Consults.
• Proactively manage overdue claims and ensure timely pend reviews per Performance Expectations. Make decisions on claims within 30 days of the Mail Received or Accrual date.
• Maintain a BBDA volume target of 25% based on approved claims.
• Ensure all correspondence and documentation are timely, complete, and accurate.
• Deliver accurate, professional, and consistent customer service to both internal and external clients.
• Respond promptly to customer emails and voicemails per Claim Management Guidelines.
• Initiate discussions with consultants regarding skill development, authority releases, and quality improvements.
• Work toward proficiency and independence to secure authority releases.
• Foster a positive team environment by sharing encouraging feedback.
• Treat everyone with respect and foster a positive work culture by assuming good intentions from others.
• Actively participate in team meetings, such as huddles, roundtables, and training sessions.
• Follow company security policies, ensuring information confidentiality and integrity.
• Engage in projects aimed at improving processes, enhancing business practices, and increasing customer acquisition or retention.
• Prioritize tasks and meet deadlines, efficiently managing multiple tasks simultaneously.

What our Client is Looking For:

• Bachelor’s degree in Nursing, PHRN License preferred, but not required.
• 1-2 years of relevant experience, ideally in a high-velocity setting, is advantageous.
• Experience handling healthcare accounts.
• Proficient in Excel and other Microsoft Office applications.
• Sharp attention to detail, skilled at identifying data errors or inconsistencies.
• Excellent organization and multitasking abilities.
• Strong verbal and written communication skills.
• Capable of handling confidential information responsibly.
• Problem-solving skills, able to work independently with minimal supervision.
• Adaptable and resilient when facing change.
• Effective time-management skills, with the ability to prioritize tasks.
• Customer service skills, especially the ability to empathize with customers facing challenging situations.

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About Us
Lennor Metier Consulting is a top recruitment agency and Headhunters licensed by DOLE. We specialize in IT, Finance, Engineering, Sales & Marketing, Supply Chain, HR & Executive Search. With expertise spanning multiple industries, we leverage our extensive network and industry knowledge to connect leading organizations with top-tier talent, ensuring successful placements that drive business growth and success.
--- We kindly request your patience as we receive a significant number of applications. Rest assured that our team will update your application's status soon. In the meantime, we encourage you to follow our Linked In page to stay informed about future opportunities and company updates.
Job Types: Full-time, Permanent
Benefits:

• Health insurance

Schedule:

• Night shift

Application Question(s):

• What's your expected Salary?
• What's your current salary?
• How soon can you start?