Senior BPM Associate (Appeals and Grievances Intake)
- Taguig City, Metro Manila
- Permanent
- Full-time
- Provide support services to team members triaging and completing intake requests for appeals and grievances into system
- Request medical records or other documentation as needed to complete appeal and grievances
- Maintain accurate and complete documentation of required information that meets quality standards
- Protect the confidentiality of the member information and adheres to the company policies regarding confidentiality
- Perform other duties as assigned
- High school diploma or G.E.D. required; associate or bachelor’s degree in health care related field an advantage
- Current unrestricted LPN license or certified Medical Assistant designation an advantage but not required
- Minimum of one year experience in a health care related field. Preferred setting is hospital, medical doctor’s office, or health insurance company.
- Appeal and grievance experience preferred.
- Experience with medical terminology and concepts used in the healthcare delivery system, provider office, or the insurance industry is required.
- Computer literacy to include Microsoft Office products
- Advanced technical skills for use of hardware and software with a high degree of accuracy.
- Excellent oral and written communication skills for representation of clear and concise results. Ability to manage significant workload, and to work efficiently under pressure, meeting established deadlines with minimal supervision.
- Strong time management skills
- Must possess high degree of accuracy, efficiency, and dependability
- Effective written and verbal communication and feedback
- Effective organizational skills with ability to be flexible and prioritize tasks
- Knowledge of educational assessments and learning strategies
- Must be knowledgeable of and able to use standard, basic grammar, punctuation, and spelling in English