Claims Processor

4 weeks ago

Metro Manila Philippines Buscojobs Full time

Job Description

Provides administrative support in the claims process by assisting with preparation, documentation, and communication involved in handling claims. Ensures smooth and efficient claims processing, supporting claimants and internal teams in various claims management tasks.

Responsibilities:

  • Input claim data into the system, ensuring accuracy, completeness, and proper filing.
  • Assist in collecting and organizing necessary documentation for claims, including medical reports, receipts, and forms.
  • Analyze claims data to identify discrepancies, fraud, or errors and escalate complex claims to senior staff or managers.
  • Conduct initial investigations to gather additional information or verify claim details when necessary.
  • Assist in negotiation or determination of appropriate settlements within guidelines.
  • Follow up with clients, healthcare providers, or third parties to ensure documentation is received for timely claim resolution.
  • Communicate with clients, vendors, adjusters, and internal departments for information requests or clarifications.
  • Answer inquiries from claimants or policyholders regarding claim status, documentation, and timelines; provide updates as needed.
  • Maintain accurate and organized physical or electronic files for each claim.
  • Ensure compliance with industry regulations, company policies, and procedures related to claims.
  • Provide general administrative support such as scheduling meetings and preparing claim-related reports.
  • Assist in preparing reports on claims processing performance or trends for management.

Qualifications:

  • Graduate of any 4-year bachelor's degree.
  • 2–4 years experience in Non-Motor Claims or prior experience in a claims department or working with insurance claims is a significant advantage.
  • Experience in handling properties, cargo, and OFW-related accounts.
  • Prior administrative or customer service experience, preferably in insurance, healthcare, or financial services.
  • Strong organizational and multitasking skills.
  • Strong analytical capabilities.
  • Proficient in Microsoft Office Suite (Excel, Word, etc.) and familiarity with claims management software.
  • Attention to detail and high level of accuracy.
  • Strong communication skills, both written and verbal.
  • Ability to handle confidential information with discretion.
  • Team-oriented and proactive in assisting other claims staff.
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