Current jobs related to Claims Operations Analyst - Quezon City - ECLARO
-
Data Analyst/Claims
20 hours ago
Quezon City, National Capital Region, Philippines Diversified Services Solutions Inc. Full time ₱800,000 - ₱1,200,000 per yearWe are seeking a detail-oriented and analytical Data Analyst – Claims to join our team. The ideal candidate will be responsible for analyzing claims data, identifying trends and anomalies, and providing actionable insights to improve operational efficiency, reduce costs, and enhance customer outcomes. This role bridges data analytics with claims...
-
Sr. Claims Analyst
3 days ago
Makati City, National Capital Region, Philippines Manulife Full time ₱1,200,000 - ₱3,600,000 per yearThis Sr. Claims Analyst position is responsible for the overall review, assessment, and decision of claims.Position Responsibilities:Determine eligible benefits based on documents submitted and policy provisions.Adjudicate claims and determine corresponding recommendation or decision within prescribed approval limits and within the defined turnaround...
-
Claims Analyst
4 weeks ago
Quezon City, Philippines 1 Cooperative Insurance System of the Philippines Life and General Insurance Full timeResponsibilities Updates claims database every time processed claims have new status; Processes all received claims; Coordinates with Medical Underwriting Consultant claims that needs medical expert opinion; Attends to agents and clients queries regarding status of their claims; Performs other tasks as required by immediate superior and/or higher Management....
-
Claims Analyst
1 week ago
Makati City, National Capital Region, Philippines Pioneer Your Insurance Full time ₱300,000 - ₱600,000 per yearYOUR ROLEVerification of cover in order to determine if indeed there is coverage/policy in-force when the loss occursMakes the necessary recommendation on a claim (such as for final action or to require further documents or information) or makes a final decision on claim, in accordance with the claim's authorityHandles the necessary communication that should...
-
Medical Claims Reimbursement Analyst
2 weeks ago
Makati City, National Capital Region, Philippines InLife Health Care Full time ₱600,000 - ₱1,200,000 per yearJOB PURPOSE:Responsible for analyzing, adjudicating, auditing and processing of claims (Member's Reimbursement) according to set medical guidelines, policies within the agreed SLAs (Service Level of Agreements).Principal Accountability:Ensures accurate and timely processing of claims from medical service providers within authority limits. This...
-
claims manager
1 week ago
Makati City, National Capital Region, Philippines MANILA BANKERS LIFE INSURANCE CORP Full time ₱1,500,000 - ₱2,500,000 per yearAbout the role This full-time Claims Manager role at MANILA BANKERS LIFE INSURANCE CORP' in Makati City Metro Manila is an exciting opportunity to join a leading insurance provider. As Claims Manager, you will be responsible for overseeing the efficient and effective processing of insurance claims to provide high-quality service to our customers.What you'll...
-
Claims Supervisor
1 week ago
Makati City, National Capital Region, Philippines Phil Care Manpower Full time ₱324,000 per yearJOB BRIEF:The Claims Supervisor will oversee a team of claims adjusters and ensure timely and accurate processing of insurance claims. This role involves supervising daily operations, providing guidance and training, monitoring performance metrics, and ensuring compliance with company policies and regulatory requirements.DUTIES AND RESPONSIBILITIES:Supervise...
-
Claims Administrator
2 weeks ago
Paranaque City, Calabarzon, Philippines Athens Services Full time ₱45,000 - ₱80,000 per yearSummaryThis new role will optimize the growth of the Claims Department. Emphasis in Subrogation, Auto, Workers Comp, and General Liability. Detailed oriented and eager to learn. Candidate will assist with all Company claims related events, contacting involved parties within established timelines through telephone and written communication. Review...
-
Claims Lead
3 days ago
Makati City, National Capital Region, Philippines Manulife Full time ₱1,500,000 - ₱3,000,000 per yearThis Claims Lead will be responsible for overseeing and managing the daily operations of the claims team. This role involves ensuring efficient processing of claims, maintaining high standards of customer service, and guiding team members to achieve performance targets. The Claim Lead acts as a liaison between the claims team, other departments, and external...
-
Claims Senior Associate
7 days ago
Quezon City, Philippines Manulife Insurance Malaysia Full time***Nous utilisons des* *pour fournir des statistiques qui nous aident à vous offrir la meilleure expérience sur note site. Vous y trouverez des renseignements sur les témoins, ou vous pouvez les désactiver si vous préférez. Toutefois, en continuant d’utiliser le site sans modifier les paramètres, vous consentez à notre utilisation de***Claims...
Claims Operations Analyst
4 weeks ago
Overview
ECLARO Quezon City, National Capital Region, Philippines
Claims Operations Analyst
Responsibilities- Intake, triage, route and assign claims to appropriate resources.
- Comply with all regulatory requirements, company mandates and policies.
- Prepare claims correspondence including assigning claim numbers and sending acknowledgement letters.
- Properly document claim files, including notes and diaries, documents in ImageRight and claimant details.
- Manage and update claims information for changes in status, parties, notifications, filings, etc.
- Review and record medical bills, police reports, contracts, legal bills, and other claim file documents.
- Complete claims financial transactions including claim payments, vendor invoices, attorney expenses, etc.
- Process and document returned checks, voided checks, credits and other financial transactions.
- Run reports for fraudulent claim research; report claims to ISO and other agencies as required.
- Run OFAC and other sanctions clearance on claims indemnity and expense payments.
- College degree preferred
- 5+ years in Commercial / Healthcare Claims
- Ability to exercise independent judgment and make critical business decisions effectively.
- Seniority level: Mid-Senior level
- Employment type: Full-time
- Job function: Administrative and Other
- Industries: Staffing and Recruiting and Insurance
