Job Description: Claims Inspection Representative

Position Summary

The Claims Inspection Representative is responsible for handling claims review through an established checklist to ensure accurate claim requirements are met before it is released to the insurance.

Job Responsibilities

• Conduct thorough reviews of submitted claims by applying a standardized checklist of requirements to ensure accuracy, completeness, and compliance with internal policies and payer guidelines.
• Accurately identify discrepancies, errors, or non-compliance issues—referred to as Failpoints—during the claims review process. These findings must be clearly documented and promptly communicated to the appropriate internal departments to initiate necessary corrective actions and ensure process integrity.
• Maintains accurate patient information in relevant Acelis Connected Health data management systems.
• Applies knowledge of company processes and procedures to respond to incoming communication from insurance companies, patients and internal departments.
• Performs other related duties as assigned.

Minimum Requirements

• College diploma or equivalent, but more education, especially in management or healthcare, is preferred.
• Minimum of 2 years of experience in healthcare accounts (preferably Revenue Cycle Management work experience).
• One to two years data processing experience preferred
• One to two years customer service or provider relations experience preferred
• Proficiency with technology, especially computers, software applications, and phone systems.
• Good verbal and written communication skills.
• Strong understanding of company products, policies, and services.

Competencies

• Fostering Teamwork
• Commitment to Job Deliverables
• Decision making
• Attention to Details
• Attention to Communication
• Customer Orientation
• Analytical Thinking
• Leadership
• Trustworthiness and Ethics
• Problem Solving
• Technical Expertise
• Managing Change
• Managing Performance
• Adaptability
• Initiative
• Interpersonal Skills
• Thoroughness
• Self Confidence
• Stress Management
• Personal Credibility
• Flexibility

Communication Skills

• Excellent interpersonal skills
• Detailed & Team Oriented
• Professional communication & Writing
• Organization/Time Management Skills

Technical Skills

• Detail-oriented
• Basic Excel, Word and Outlook experience required.
• Demonstrates proficiency and accuracy using Alere Home Monitoring data management systems which are directly related to the specific job function.
• Strong Computer/Software Skills

Physical Abilities

• Must be able sit at a standard workstation for long periods
• Must be able to work with a standard computer and monitor using keyboard
• No lifting required for this position
• Must have the ability to get to work on time and work for the entire assigned shift
• Must be able to work a night shift from minimum 8:00 pm to 8:00 am Philippine Standard Time.

Significant Work Activities

• Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day)

Job Details

• Job Family: Accounts Payable & Receivables, Credit & Collection, & Payroll
• Division: HF Heart Failure
• Location: Philippines > Taguig City : Five/Neo Building
• Work Shift: Standard
• Travel: Not specified
• Medical Surveillance: Not Applicable
• Base Pay: N/A (In specific locations, the pay range may vary from the range posted.)

About Abbott

Abbott is about the power of health. For more than 135 years, Abbott has been helping people reach their potential — because better health allows people and communities to achieve more. With a diverse, global network serving customers in more than 160 countries, we create new solutions — across the spectrum of health, around the world, for all stages of life. Whether it's next-generation diagnostics, life-changing devices, science-based nutrition, or novel reformulations, we are advancing some of the most innovative and revolutionary technologies in healthcare, helping people live their best lives through better health.

The people of Abbott come to work each day with relentless energy, enthusiasm and a promise to enhance the health and well-being of millions of people. They push the boundaries to help manage and treat some of life's greatest health challenges. We invite you to explore opportunities at Abbott, to see if your talents and career aspirations may fit with our openings.

An equal opportunity employer, Abbott welcomes and encourages diversity in our workforce.