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Job Summary:

Benefit Specialist is responsible for evaluating on going claims or benefit reimbursement and determining if the services covered under the policy is eligible for claims payment in Promise and Beacon.

Key Accountabilities:

•Check and analyze transactions to ensure accuracy, consistency and client satisfaction, as well as ensure that quality standards are met
•Accountable for ongoing claims payment of benefit reimbursement
•Evaluate and determine if services are covered under the policy
•Interpret policy provisions by state and determine benefits payable.
•Evaluate if services being reimbursed are consistent with the Plan of Care (hours, dollars etc).
•Coordinate and apply Medicare and other governmental agency benefits.
•Confirm Clinical reviews are up to date prior reimbursement

Minimum Skills Required to Hire:

(For IJP) The candidate:

•Must have at least 1 year tenure in current position
•Must be meeting or exceeding performance metrics in the current position
•Must not have any attendance issues and have not received any disciplinary action


•College/University graduate preferably with previous related work experience in the financial services

Technical Skills:

•Average to above average keyboarding and PC skills, including familiarity with shortcut key functions
•Experienced in MS Excel

Soft Skills:

•Average to above average reading comprehension and communication skills
•Average to above average problem-solving and decision making skills
•Average to above average organization and prioritization skills
•Critical attention to detail for functions such as entering, verifying and comparing data.
•Understands the value of Customer Service
•Excellent ability to handle multiple tasks and prioritize appropriately
•Flexibility to adapt to new methodologies for processing work.
•Adapt to changes in procedures and maintain quality standards Communication skills - email correspondences

Minimum Skills Requirements to Go-live:
Product Specific Knowledge

•Basic knowledge of Long Term Care Product and Claims functions
Process Specific Knowledge
•Knowledge of company claims transaction
•Able to identify complex and non-complex transaction
•Knowledge of Promise Payment processing
•Knowledge of Beacon Unmatched Mail Processing

Tools Specific Knowledge

•Pega System Promise
•Pega System Beacon
•Pega System CSC

About Manulife
Manulife Financial Corporation is a leading international financial services group that helps people achieve their dreams and aspirations by putting customers' needs first and providing the right advice and solutions. We operate as John Hancock in the United States and Manulife elsewhere. We provide financial advice, insurance, as well as wealth and asset management solutions for individuals, groups and institutions. At the end of 2016, we had approximately 35,000 employees, 70,000 agents, and thousands of distribution partners, serving more than 22 million customers. At the end of 2016, we had $977 billion (US$728 billion) in assets under management and administration, and in the previous 12 months we made almost $26 billion in payments to our customers.
Our principal operations are in Asia, Canada and the United States where we have served customers for more than 100 years. With our global headquarters in Toronto, Canada, we trade as 'MFC' on the Toronto, New York, and the Philippine stock exchanges and under '945' in Hong Kong.
Manulife is committed to supporting a culture of diversity and accessibility across the organization. It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will consult with applicants contacted to participate at any stage of the recruitment process who request an accommodation. Information received regarding the accommodation needs of applicants will be addressed confidentially.

Primary Location : PH-Lapu Lapu City-CEBUMBPS-Manulife Building, Mactan Newtown Center Mactan Circumferential Road

Business Unit : JH Insurance
Job Function : Insurance
Job Type : Standard
Schedule : Full-time