ShineBright Interview

𝘽𝙖𝙘𝙠 𝙤𝙛𝙛𝙞𝙘𝙚 𝙀𝙥𝙖𝙮𝙢𝙚𝙣𝙩 𝘼𝙘𝙘𝙤𝙪𝙣𝙩
ᴘʀᴏᴊᴇᴄᴛ ʙᴀsᴇᴅ
P29,000 - P34, 000
Ortigas, Pasig City

𝙃𝙞𝙧𝙞𝙣𝙜❗📣
𝙃𝙍 𝘼𝙨𝙨𝙤𝙘𝙞𝙖𝙩𝙚 - 𝙏𝙧𝙖𝙞𝙣𝙞𝙣𝙜 𝙖𝙣𝙙 𝙋𝙧𝙤𝙟𝙚𝙘𝙩 𝘾𝙤𝙤𝙧𝙙𝙞𝙣𝙖𝙩𝙤𝙧
𝙈𝙖𝙠𝙖𝙩𝙞 𝘾𝙞𝙩𝙮
𝙃𝙮𝙗𝙧𝙞𝙙 𝙎𝙚𝙩 𝙐𝙥
𝙋, 𝟯𝟬, 𝟬𝟬𝟬 (salary)

Send your resume at: [email protected]

WERE HIRING ❗❗
📌Qualifications
• Candidate must have a Bachelor's/College Degree. Medical background is preferred but not required. (Non-Negotiable)
• Must have experience in Health claims work experience. (Non-Negotiable)
• Candidate must have at least 2 to 3 years experience in adjudicating health claims. (Non-Negotiable)
• Must possess excellent communication skills with the ability to effectively articulate health product terms and conditions as well as the reason for claims decision. (Non-Negotiable)
• Call center experience is preferred. (Non-Negotiable)
• Above-average working knowledge of insurance operational processes. (Non-Negotiable)
• Customer-centric and must advocate the "Customer First" mindset.
• Highly developed sense of integrity.
• Pleasant, patient, and friendly attitude; sociable personality.
• Detail-oriented, highly organized, and possesses problem-solving skills.
• Excellent and strong negotiation and influencing skills.
Job Description
1. Properly adjudicate reimbursement claims on outpatient, inpatient benefits of policyholders on a health policy.
2. Accurately determine if a medical condition is a covered benefit based on the policy provisions, terms, and conditions.
3. Adjudicate reimbursement claims in accordance with different processes within defined authority limits and escalate to the next level approver if necessary.
4. Conduct proper investigations on claims if needed.
5. Research required information using available resources, and handle, manage, and resolve customer complaints.
6. Follow up on complicated customer inquiries as required.
7. Accurately document claim files with notes, evaluations, and decision-making processes based on departmental procedures.
8. Utilize anti-fraud policies or protocols in place to mitigate fraud for submitted claims or pre-approval requests. Escalate where necessary in accordance with claims guidelines and procedures.
9. Provide exceptional service and ensure a seamless customer experience by meeting defined customer experience targets.
10. Provide backup for any support functions.
11. Accomplish tasks that may be assigned by his/her manager on an ad hoc basis.
12. Accomplish company goals by taking ownership of work responsibilities and constantly identify opportunities for work process improvement.
13. Ensure legal compliance by following company policies, procedures, guidelines, as well as local insurance regulations and statutes.
14. Adhere to strict data protection protocols by keeping claims and sensitive medical information highly confidential.

URGENT HIRING ❗
📌 TECHNICAL DELIVERY MANAGER (P 110,000 SALARY)

Project Based
Location: Taguig City, BGC
Work Schedule/Setup: Full Onsite, Monday to Friday 8 am to 5 pm
Preferably with experience in Project Management and as Technical Delivery Lead in Information Technology.


Job Description
• Works with concerned units within CDD in ensuring projects are properly staffed in
terms of numbers and skills.
• Works with development lead and coordinates the tasks of the different sections to
ensure that activities progress on schedule and within the prescribed budget.
• Works with the delivery managers to review detailed plans and budget for application
system development.
• Collaborates with Business Relationship Management Requirements Development
Department for the initial assessment of business requirements.
• Works with the Quality Assurance division in making sure defects are fixed within the
agreed turnaround time.
• Consults with Enterprise Architecture Team and Solutions team on technology standards
and architecture direction.
• Participates in the evaluation and selection of vendor systems or solution.
• Performs development lead functions including technical design review, source code
inspection and defect management. The development lead functions may extend to
projects with either internal or external developers.
• Performs other related functions that may be assigned from time to time.

Qualifications
• Bachelor's degree in Computer Science, Information Technology, or related field.
Advanced degrees such as Master's in relevant disciplines are advantageous but not
always required.
• Must have minimum 3 years of experience as a Delivery Manager or Project
Manager. (Non-negotiable)
• Must have minimum 3 years of experience in software development and project
management. (Non-negotiable)
• Must have prior experience in a technical leadership role, overseeing the delivery of
multi-technology and multi-platform solutions. (Non-negotiable)
• Strong understanding of software development lifecycle methodologies (e.g., Agile,
Waterfall). (Non-negotiable)
• Must be proficient in various programming languages and development
frameworks. (Non-negotiable)
• Experience working with cross-functional teams and coordinating activities to ensure
project success.
• Must be knowledgeable with budgeting and resource allocation processes in the context
of application system development. (Non-negotiable)
• Experience in evaluating and selecting vendor systems or solutions.
• Excellent communication skills, both written and verbal, with the ability to effectively
communicate technical concepts to non-technical stakeholders. (Non-negotiable)

Good to have
• Certifications such as Project Management Professional, Certified Scrum Master
(CSM), or related certifications are desirable.
• Experience with DevOps practices and tools would be beneficial.
• Familiarity with regulatory requirements and compliance standards relevant to the
industry (if applicable).

Please send your resume at [email protected]

URGENT HIRING ❗
ACCOUNTING SENIOR SPECIALIST
📌 Details:

Project Based Setup
Makati City
Hybrid Setup (3 days onsite and 2 days WFH) Dayshift Monday to Friday
Offer: 35,000K with Benefits
Must have an experience as accounting and in SAP

Please send your resume at [email protected]

Urgent hiring‼️
look here 👀
For all interested applicants,
please email your resume at [email protected]
Good luck Job seekers ☺

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