Job Description

Responsible for monitoring, facilitating, and reviewing processes and information to determine if standard procedures set forth were accurately used.

Responsibilities

  • Medical Information Review
     
    • Data entry of medical and bill information.
    • Checks data initially entered for accuracy and completeness.
    • Processes client information.
    • Analyzes medical information for appropriateness.
    • Summarizes information to prepare reports as necessary.
    • Conducts quality assurance on processes and documents.
    • Contacts with stakeholders, either through phone call or email to coordinate medical treatment schedule.
    • Approves payments of medical bills.
    • Assists and collaborates with onshore partners in resolving and put claims to closure.
       
  • Finance Information Review
     
    • Act as the point of contact in the absence of a Team Lead or Supervisor
    • Handle complex scenarios that would require further analysis and decision making (I.e., Client account reconciliation, billing history, etc.)
    • Processes client information.
    • Ensure the accuracy of financial data that is provided both internally and externally.
    • Summarizes information to prepare reports as necessary and be able to explain these financial reports.
    • Conducts quality assurance on processes and documents.
    • Facilitates any additional training needed by the team.
       
  • Business Process Support
     
    • Analyzes and resolves any issues and inquiries regarding matters of work in a customer-oriented approach.
    • Routes tasks to appropriate processor by utilizing internal systems.
    • Refers matters beyond limits of authority and expertise to immediate superior for direction.
    • Upholds the Crawford Code of Conduct by protecting the confidentiality of information.
    • Adheres to the standard operating procedures (SOP) and turnaround time set by the company.
    • Performs variety of administrative duties and other related tasks from time to time as assigned to contribute to other business processes.

Qualifications

  • Bachelor’s Degree or equivalent professional experience in lieu of a degree
  • At least two (2) years related work experience.
  • Must:
     
    • Proficient typing skills.
    • Good communication skills.
    • Proficient in word processing and spreadsheet softwares.
    • High analytical skills in reviewing medical information or financial information.
       
  • Desired:
     
    • Competence in case management outcomes.
    • Knowledge and understanding of QI and QA practices.
       
  • Ability to multi-task, prioritize and manage time effectively.
  • Keen attention to details in order to produce quality output.
  • Maintains high degree of professionalism and confidentiality.
  • Interpersonal skills - Able to work independently and as a team member.


Job Details

Role Level: Associate Work Type: Full-Time
Country: Philippines City: Manila Metro Manila
Company Website: https://www.crawco.com Job Function: Operations Management
Company Industry/
Sector:
Insurance

What We Offer


About the Company

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