MEMBERS DATA ANALYST

Be part of our growing TEAM!

We are looking for goal-oriented individuals to fill-in the MEMBERS DATA ANALYST Role.

JOB SUMMARY

Responsible for performing membership processing activities, including the review, validation, encoding, and monitoring of applications, endorsements, and member-related transactions in accordance with established departmental procedures, company policies, and regulatory requirements. Ensures the timely and accurate processing of membership requests, proper documentation, and maintenance of updated member records while meeting established turnaround time (TAT) and service level agreement (SLA) standards.

JOB RESPONSIBILITIES:

• Review endorsements received through email, Messenger, fax, and other communication channels to verify the completeness of MDA requirements, and respond to client inquiries or requests for clarification as needed.
• Prepare and issue the appropriate action memos or email notifications for every endorsement received, including completed transactions and processing updates.
• Screen all applications and other endorsements to ensure the completeness of MDA requirements and follow the established step-by-step membership processing procedures.
• Timely submits medical evaluation results to the Medical Director for approval.
• Ensure the timely and accurate processing and encoding of approved additional member applications, lost card requests, amendments, cancellations, renewals, and reactivation/reinstatement requests in accordance with departmental standard processes.
• Ensure and timely endorsed the done processed and payment received to the Billing Section for billing of applicants and posting within the agreed turnaround time (TAT).
• Promptly endorsed the payment received to accounting department for validation.
• Ensure and monitor the timely release of ID cards to clients within the agreed turnaround time (TAT).
• Maintain accurate and organized filing of all files and documents, both electronic and hard copy, ensuring they are properly stored and readily accessible in accordance with departmental standards and for audit compliance purposes.
• Professionally answers all phone calls and complaints explain behind disapproval of application.
• Can evaluate and address escalated concerns in a timely and appropriate manner.
• Effectively coordinates concerns with other departments, enhancing communication and interdepartmental collaboration.
• Real-time update of daily and monthly report of processed accounts.
• Ensure adherence to departmental and company policies, rules, and regulations.

JOB QUALIFICATIONS:

• Graduate of any four (4) years course
• Preferably with experience in the HMO industry.
• At least one (1) year of relevant work experience.
• Proficient in Microsoft Office applications (Excel, Word, and PowerPoint).
• Strong interpersonal, customer service, and communication skills with a positive, professional work ethic.
• Detail-oriented with excellent organizational, analytical, and problem-solving abilities.
• Able to work independently, prioritize tasks, and take ownership of responsibilities.
• Flexible, adaptable, and capable of handling pressure while managing multiple priorities.
• Willing to work overtime and go the extra mile to support business needs and team goals.

VALUCARE provides our employees with a total rewards package, which includes competitive market benefits:

• Guaranteed leave benefits on your first day
• Guaranteed HMO on your first day
• Performance based bonus
• Life Insurance Coverage
• Heath care benefit coverage up to 3 dependents
• Retirement benefits
• Annual Salary Increase
• Birthday Leave
• Profit Sharing
• Uniform Benefit
• Medicine Allowance
• Vitamins Allowance

In VALUCARE, we promote an environment that allows everyone to be at their best and explore their creativity.