Facility Claims Specialist - Potential WFH after Training

Location & Work Setup

• Location: Makati
• Employment Type: Full-time
• Shift: 6:00 AM – 2:00 PM (PH Time)
• Work Setup: Onsite for the first 6 months, with potential work‑from‑home eligibility thereafter based on performance and business needs

Pay Rate

Up to Php 45,000.

About the Role

We are looking for a highly experienced Facility Claims Specialist with strong hands‑on expertise in US healthcare facility claims adjudication. This role is ideal for a candidate who has worked in a payer, TPA, or managed care environment and can independently review, analyze, and resolve complex hospital claims with accuracy, consistency, and sound judgment.

Key Responsibilities

• Review and adjudicate hospital and facility claims, including inpatient, outpatient, emergency room, ancillary, Home Health, and SNF claims, in accordance with benefit plans, policies, and standard procedures.
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