Medical Associate
Cebu
• Review member benefits and coverage using company systems and guidelines • Check if requested services and procedures are covered or not covered • Approve or deny coverage based on plan rules and policy details • Update authorizations and case information in the system • Process discharging of cases once completed or resolved • Triage and route cases to the correct team or queue • Verify member eligibility and benefit limits • Write clear and accurate case notes and rationale • Follow quality, compliance, and turnaround time standards • Coordinate with QA and other teams when clarification is needed • Handle high-volume workload while keeping accuracy and quality
Shearwater Health Advisors Inc., full_time
Jul 2025 to Present