SME | Insurance Claims

6 days ago


Davao City, Davao, Philippines Sutherland Full time

Job Description

KEY RESPONSIBILITIES OF THE SME

  1. Empower the Work: Create and facilitate Huddle Sessions to equip staff with fundamental skills and knowledge.
  2. Conduct BQM / Remedial training for the folks in nesting. Also conduct floor interventions for BQ teams.
  3. Strengthen relationships: Establish and maintain communication with clients and/or team members; understand needs, resolve issues, and meet expectations.
  4. Take the lead: Deliver new hire training for the business, ensuring to provide a good learning experience for new hires and equipping them with the relevant skill set to meet production goals from the first month post-nesting. Partner with quality and training manager to identify skill and knowledge gaps that lead to an unstable performance trend. Work with the training manager to prepare training content to run a BQ intervention for the business and cater learning via the update management process and new launches.
  5. Support the team with complex queries and fill out accurate reports.
  6. Support the team manager and ensure the team delivers against key service level metrics while creating value for clients by impacting business outcomes.
  7. Handle phone calls and transactions for the program.
  8. Supervise and coach learners in nesting & BQM type environments.
  9. Coach and give feedback to trainees to help them fulfill performance metrics.

Qualifications

  1. Minimum 24 months of insurance experience managing customer-facing accounts, preferably managing processes such as intake, scheduling, credentialing, medical bill reviews, and disabilities.
  2. Excellent data mining skills.
  3. Ability to think outside of traditional roles to evaluate business implications.
  4. Ability to interpret data, identify trends, and make suggestions for improvements.
  5. Strong verbal and written communication skills; able to communicate in a clear, constructive, and professional manner.
  6. Demonstrated leadership skills; able to take the lead in making improvements and resolving issues.
  7. Experience in blended operations which involve back-office work, making outbound, and receiving inbound calls.
#J-18808-Ljbffr

  • Davao City, Davao, Philippines Outsource USA Full time

    Job DescriptionWe are seeking a Virtual Assistant to join our Insurance Support team. As a key member of our team, you will be responsible for verifying insurance details, processing claims, and ensuring accuracy across various insurance policies.About the TeamOur team is passionate about delivering exceptional insurance verification solutions. We work...


  • Davao City, Davao, Philippines AIA PHILIPPINES LIFE AND GENERAL INSURANCE COMPANY INC. davao Full time

    AIA PHILIPPINES LIFE AND GENERAL INSURANCE COMPANY INC. DavaoJob DescriptionEmployee Recognition and RewardsCommission, Quarterly GiftsDescriptionAn Insurance Coordinator is responsible for managing insurance-related tasks within an organization, ensuring compliance with policies, and coordinating with insurance providers, clients, and internal departments....


  • Davao City, Davao, Philippines Sutherland Full time

    Job DescriptionSutherland is a leading provider of business process outsourcing (BPO) solutions, and we are seeking an experienced Claims Operations Manager to lead our team of claims specialists handling short-term and long-term disability claims.This is a dynamic role that requires strong leadership skills, attention to detail, and a passion for delivering...


  • Davao City, Davao, Philippines Sutherland Full time

    Job Overview:We are seeking a skilled Insurance Claims Specialist to join our team at Sutherland.About the Role:This is an excellent opportunity for a motivated individual to take on a leadership role and make a real impact in our customer service operations.Your Key Responsibilities:You will be responsible for empowering our staff with the necessary skills...


  • Davao City, Davao, Philippines Fair Trade Outsourcing Full time

    About UsFair Trade Outsourcing Ph Inc. is a global outsourcing center that provides impact sourcing work for companies worldwide. Our main office is located in Philadelphia, Pennsylvania, with a network of delivery centers in the Philippines, Mexico, and Ghana.We have four centers in the Philippines, each with over a hundred employees. As a member of our...


  • Davao City, Davao, Philippines Outsource USA Full time

    About Outsource USAWe are a leading provider of virtual assistance services, dedicated to delivering exceptional support to our clients. Our team is passionate about providing accurate and efficient insurance verification solutions.As a Virtual Assistant in our Insurance Support team, you will play a crucial role in verifying insurance details, processing...

  • Insurance Agent

    2 weeks ago


    Davao City, Davao, Philippines Flair Marielle Rollan Full time

    ShareJob DescriptionDescriptionClient Consultation: Meeting with individuals or businesses to assess their insurance needs, providing guidance on various insurance products (e.g., life, health, auto, property, or business insurance), and explaining policy details.Sales and Marketing: Actively seeking new clients through marketing, networking, cold-calling,...


  • Davao City, Davao, Philippines Outsource USA Full time

    About the PositionWe are looking for a skilled Virtual Assistant to join our Insurance Support team. In this role, you will be responsible for verifying insurance details, processing claims, and ensuring accuracy across various insurance policies.The Ideal CandidateThis is an excellent opportunity for a detail-oriented individual who is fluent in English and...

  • Virtual Assistant

    4 days ago


    Davao City, Davao, Philippines Outsource USA Full time

    Job OverviewWe are seeking a highly skilled Virtual Assistant to join our Insurance Support team. As a key member of our team, you will be responsible for verifying insurance details, processing claims, and ensuring accuracy across various insurance policies.About the RoleThis is an exciting opportunity for a motivated individual who is fluent in English and...


  • Davao City, Davao, Philippines Optum, a UnitedHealth Group Company Full time

    Primary Responsibilities:Contract reading of payment dispute.Working on the Provider side.Checking with the insurance to verify claim status and collect unpaid claims.Process claims payment, Denial Management, Claim statusing.JOB QUALIFICATIONSCompleted at least 2 years in college.With minimum 12 months experience of Healthcare Account Receivable/Collections...

  • Insurance Agent

    2 weeks ago


    Davao City, Davao, Philippines St. Peter Lanang Branch Full time

    ShareJob DescriptionDescriptionWe are seeking a motivated and customer-focused Insurance Agent to join our team. In this role, you will identify client needs, offer tailored insurance solutions, and build long-term relationships. You will handle policy sales, assist clients with claims, and provide expert advice to help them make informed decisions about...


  • Davao City, Davao, Philippines CoolBlue VA Full time

    Virtual Medical Assistant – Insurance Specialist (Remote)We are looking for a detail-oriented Virtual Assistant with a strong medical background and expertise in Medical Insurance processes. If you have experience handling Insurance Eligibility, Pre-authorizations, Referrals, and Claims, we encourage you to apply and become a valuable part of our...

  • Insurance Agent

    2 weeks ago


    Davao City, Davao, Philippines GOTERA MARKETING AND ALLIED SERVICES Full time

    ShareJob DescriptionDescriptionIdentify and approach potential clients to sell insurance policiesAssess client needs and recommend appropriate insurance coverage (life, health, auto, property, etc.)Explain policy details, coverage options, and benefits to clientsProcess applications, claims, and policy renewals accuratelyBuild and maintain strong...


  • Davao City, Davao, Philippines Snapscale Full time

    Serve as a key team member in the Commercial Lines Department, including educating current clients and attracting new ones.Provide proposals for agency producers.Quote policies with top-rated carriers in the industry, such as Auto-Owners, Liberty Mutual, The Hartford, and West Bend.Maintain up-to-date knowledge of products and markets.Focus on client...


  • Davao City, Davao, Philippines Sutherland Full time

    Company DescriptionSutherland is seeking a dynamic and experienced Team Manager to lead a team of claims specialists handling short-term and long-term disability claims. In this role, you will oversee daily operations, ensure compliance with client and industry standards, and foster a high-performing team environment. You'll be pivotal in driving operational...


  • Davao City, Davao, Philippines Outsource USA Full time

    Now Hiring: Spanish Bilingual Insurance Verification AssistantAre you fluent in Spanish and English with a keen eye for detail in insurance verification? We're looking for a dedicated Virtual Assistant to support our team with verifying insurance details, processing claims, and ensuring accuracy across various insurance policies.Responsibilities:Verify...

  • Medical VA

    2 weeks ago


    Davao City, Davao, Philippines CoolBlue VA Full time

    Virtual Assistant Opportunity – Medical Insurance SpecialistJoin our team as a Virtual Assistant (Medical Insurance Specialist) We're looking for a dedicated professional with a medical background and expertise in medical insurance processes.ResponsibilitiesVerifying insurance eligibilityObtaining pre-authorizationsManaging referralsProcessing...


  • Davao City, Davao, Philippines Fair Trade Outsourcing Full time

    Job ResponsibilitiesThe Customer Service Representative will be responsible for handling customer inquiries via phone and email, providing exceptional service and support to ensure customer satisfaction.Key tasks include:- Responding to 70-90 phone calls per day, addressing customer concerns and resolving issues in a timely and professional manner.-...


  • Davao City, Davao, Philippines Fair Trade Outsourcing Full time

    The Medical Billing Representative posts payments received from insurance companies, cash payments, and payment plans to the patient's accounts; enters adjustments, write-offs, and reconciles the patient's accounts. The Medical Billing Representative reviews claims for non-payment, posts the zero payment to the patient's account and writes off the unpaid...


  • Davao City, Davao, Philippines Fair Trade Outsourcing Full time

    About UsFair Trade Outsourcing is a leading provider of customer service solutions. We value our employees' growth and development, offering opportunities for advancement and professional growth.Job DescriptionThe Customer Service Representative will be an integral part of our Contact Center team, responsible for handling high volumes of customer inquiries...