Dental Claims Analysts (Dentists)
Job ID: 102904 Job Views: 293 Posted: 2012-03-08 Location: Philippines Quezon City, Metro Manila
Job Description
UnitedHealth Group is working to create the health care system of tomorrow.
Already Fortune 25, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we’re doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we’re building a high-performance health care system that works better for more people in more ways than ever. Now we’re looking to reinforce our team with people who are decisive, brilliant – and built for speed.
Minimum Requirements:
Bachelor’s or Associate Degree in Dentistry.
Doctor of Dental Medicine preferred.
At least 2 years health care or health plan experience with the ability to read Dental X-Rays.
Working knowledge in using tooth numbering system.
Experience working in a BPO/Call Center is an advantage.
Good communication skills, verbal and written.
Experience in using MS Windows based PC skills (Word, Excel, Outlook)
Understanding of basic medical terminology.
Location: 24th Floor, IBM Plaza, 8 Eastwood Ave., Eastwood City Cyberpark, E. Rodriguez Jr. Ave., Libis, Quezon City
How to apply: Send CVs to Kathleen_Resulta@uhgrecruitmentservices.com, walk-in, send sms or call 0917-5790508.
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Company Information
UnitedHealth Group
24th Floor, IBM Plaza, 8 Eastwood Ave., Eastwood City Cyberpark, E. Rodriguez Jr. Ave., Libis, Quezon City Quezon City Metro Manila Philippines
Contact Name: Kathleen Resulta
Phone: 0917-5790508
Web: http://careers.unitedhealthgroup.com
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Benefits Analysts (Pharmacists)
Job ID: 102905 Job Views: 287 Posted: 2012-03-08 Location: Philippines Quezon City, Metro Manila
Job Description
Benefit Analysts
Responsibilities:
o Analyze benefit requests and secure all necessary data to ensure appropriate. implementation based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system.
o Work with Client Management to implement new and maintain existing benefit plans and client pricing in the pharmacy claim adjudication system.
o Work with Clinical Pharmacy to implement formulary updates and clinical programs in the pharmacy claim adjudication system.
o Work with Pharmacy Network Management to implement pharmacy rate changes and network additions in the pharmacy claim adjudication system.
? Ensure timely communication of any issues and/or information needed to complete a plan request.
? Develop client specific implementation plans and manage implementation processes in accordance with department protocol.
? Run queries out of the RxCLAIM adjudication system to secure all necessary information to implement plan requests.
? Develop and run macros in RxCLAIM to implement plan requests.
? Perform claim testing to ensure accurate claim adjudication.
? Maintain acceptable and appropriate quality levels and production turn around times
? Adhere to all documentation standards within the department.
? Assist with the development of process improvements for the department.
? Research and respond to all claims processing inquiries from Client Management, Clinical, and other internal department.
? Participate in team meetings.
? May be assigned to work on special projects and business initiatives.
Performance Standard
? Ability to maintain an accuracy rate of 98% or better
? Adherence to company attendance policy
? Able to work independently
? Completes assigned projects on time
Skills:
? Microsoft Office proficiency Word and Excel, specifically Advanced Excel skills -- must have ability to create Excel spreadsheet, macros, compile/analyze data for reporting;
? Strong written and verbal skills;
? Detail-oriented;
? Superior organization skills;
? Ability to work on multiple project simultaneously; and
? Excellent analytical skills.
Qualifications:
? Bachelor's Degree in Pharmacy;
? Registered Pharmacists
? Certified pharmacy technician preferred;
? 2+ years of RxCLAIM (by SXC) experience (desired); and/or
? 2+ years PBM or retail pharmacy experience (required).
http://careers.unitedhealthgroup.com
Location: 24th Floor, IBM Plaza, 8 Eastwood Ave., Eastwood City Cyberpark, E. Rodriguez Jr. Ave., Libis, Quezon City
How to apply: Send CVs to Kathleen_Resulta@uhgrecruitmentservices.com, walk-in, send sms or call 0917-5790508.
Please Login or Register to Apply for this Job
Company Information
UnitedHealth Group
24th Floor, IBM Plaza, 8 Eastwood Ave., Eastwood City Cyberpark, E. Rodriguez Jr. Ave., Libis, Quezon City Quezon City Metro Manila Philippines
Contact Name: Kathleen Resulta
Phone: 0917-5790508
Web: http://careers.unitedhealthgroup.com
View All Job Posts by this company
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