Insurance Claims Specialist

1 week ago


Project, Philippines WHR Global Consulting Full time

Insurance Claims Specialist (Motor Insurance)
Location: Madrigal Business Park, Alabang
Work Set Up: Full time, Weekdays (8:00 AM - 5:00 PM, subject for extensions depends on the urgency of the request and/or deadlines)
Salary: ₱30,000 - ₱35,000

Job Summary:
The Claims Executive oversees the end-to-end handling of complex or high-value claims, ensuring that each case is processed efficiently, accurately, and in line with regulatory and company standards. This role involves providing technical guidance to junior claims staff and supporting process improvements within the department.

Key Responsibilities:
Manage complex and high-value claims from notification to settlement
Evaluate claim reports, policy coverage, and supporting evidence for accurate decision-making
Review and approve claim assessments prepared by junior staff
Liaise with adjusters, legal teams, repairers, and policyholders for claim resolution
Recommend settlements or rejections with full justification based on policy terms and conditions
Identify potential fraud indicators and escalate as necessary
Contribute to claims policy development and process enhancement
Prepare periodic claims reports and provide insights to management

Qualifications:
Bachelor’s degree in Business, Insurance, or a related field
At least three (3) years of experience in insurance claims, preferably in motor lines
Strong knowledge of claims handling processes, insurance policies, and regulatory requirements
Excellent analytical, negotiation, and problem-solving skills
Demonstrated leadership and mentoring capabilities
Proficient in MS Office and claims management systems



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