Claims Strategy Lead

Pasig City, Metro Manila
Permanent
Full-time

29 days ago

Ready to make an impact? At Hive Health and HPPI, a subsidiary of Hive Health, we're on a mission to make healthcare radically more accessible for all-and we need passionate, driven individuals to help us make it happen. If you thrive in a fast-paced, innovative environment and want to work on solutions that truly matter, we'd love to meet you!👋🏻 Hi! We're HPPI, part of the Hive Health GroupAbout usis an HMO that is part of the Group of Companies, which is on a mission to provide the best-in-class health plans for small-medium enterprises (SMEs) in the Philippines.HPPI's 30+ years of providing care, combined with Hive Health's innovative tech capabilities, enables the Hive Health Group of Companies to offer comprehensive, hassle-free digital health plans through our all-in-one platform. Together, we are revolutionizing access to quality, affordable healthcare for millions of Filipinos, one SME at a time.ResponsibilitiesManage, lead, and build the team to ensure smooth and efficient claims operations.Develop and enhance reporting tools within the Hive Portal, ensuring data accuracy for hospital bills, procedures, and professional fees.Manage and oversee claims processing, ensuring all supporting documents are complete and accurate.Oversee claims evaluation processes for various services such as maternity, dental, and lab fees, ensuring timely payments.Drive process improvements for healthcare claims operations with a focus on automation and efficiency.Recommend and implement technological solutions to optimize workflows, leveraging operational and technical insights while being hands-on with daily processing.Collaborate cross-functionally with healthcare, finance, and product teams to ensure smooth integration of new systems and procedures.QualificationsMust be willing to work onsite in OrtigasBachelor's degree in Healthcare Administration, Business, or a related field.Experience in financial operations, systems integration, or claims management.Ability to absorb and navigate healthcare claims processesStrong analytical mindset, with a track record of deploying improvements in business processes.Experience in process automation and system integration, with the ability to work independently on solutions without reliance on product development teams.Curious, results-driven, ownership mentality with growth mindsetExcellent verbal and written communicationsCollaborative team player with the ability to adapt quickly in a fast-paced environmentPassion for innovation in healthcareJoin our team as we revolutionalize healthcare in the Philippines-and beyond!✨ Day 1 benefits for full-time employees - because we practice what we preach! Enjoy comprehensive healthcare coverage for you and your dependent, and paid time off from the start.
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