Claims Inspection Representative

The Opportunity

As the Claims Inspection Representative, you will be responsible for handling claims review through an established checklist to ensure accurate claim requirements are met before it is released to the insurance.

What You’ll Do

• 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.

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
• Analytical Thinking
• Commitment to Job Deliverables
• Leadership
• Decision Making
• Trustworthiness and Ethics
• Attention to Details
• Problem Solving
• Attention to Communication
• Technical Expertise
• Customer Orientation
• Managing Change
• Adaptability
• Managing Performance
• Stress Management
• Initiative
• Personal Credibility
• Interpersonal Skills
• Flexibility
• Thoroughness
• Self Confidence

Required Skills

Communication

• 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

• Perform some repetitive motion activities.
• Sit for long periods of time.
• Requires close vision and the ability to adjust eye focus often.
• Required to reach with hands and arms.

Work Schedule

• Must be able sit at a standard workstation for long period.
• 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.

Location

This position is based in Philippines.

Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity.

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The base pay for this position is

N/A

In specific locations, the pay range may vary from the range posted.

JOB FAMILY:

Accounts Payable & Receivables, Credit & Collection, & Payroll

DIVISION:

HF Heart Failure

LOCATION:

Philippines > Taguig City : Five/Neo Building

ADDITIONAL LOCATIONS:

WORK SHIFT:

Standard

TRAVEL:

Not specified

MEDICAL SURVEILLANCE:

Not Applicable

SIGNIFICANT WORK ACTIVITIES:

Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day)