Claims Specialist

3 weeks ago

Manila, National Capital Region, Philippines Trinity Insurance and Reinsurance Brokers, Inc Full time

COMPANY PROFILE:

Trinity is a full-line insurance broker that provides products and services in both General Insurance and Employee Benefits. For more than three decades, Trinity has transformed the lives of its clients and customers, redefining what it means to be in the business of insurance by creating products and services that are customized, personalized, and cost-effective. Through its partnership with Brokerslink, a global broking company that brings together market-leading independent brokers from more than 100 countries, Trinity is equipped to serve its clients with risk management services that they might need.

THE ROLE:

We are looking for a Claims Specialist for our Employee Benefits division who will be responsible for handling the end-to-end processing of claims, providing guidance, instruction, and direction to team members (claims staff) to achieve team objectives. The position will focus on medical claims as well as other insurance lines under Employee Benefits.

Responsibilities:

  • Coordinate with insurers, policyholders, and other stakeholders to ensure timely claims resolution.
  • Investigate and evaluate claims to determine their validity, including gathering relevant documentation, medical records, and other supporting materials.
  • Ensure claims are processed promptly and efficiently according to service level agreements (SLAs).
  • Approve or reject claims based on thorough analysis and in line with policy terms and conditions.
  • Provide guidance and support to clients, policyholders, and beneficiaries on claim-related inquiries.

Qualifications:

  • Bachelor's degree in any course. Medically-aligned degrees have an advantage.
  • At least 2 years of experience in end-to-end processing of claims, particularly in medical claims. An experience of claims in a BPO or insurance broker is an advantage.
  • Preferably knowledgeable in life insurance lines or products (HMO, GLI, Personal Accident).
  • Proficient in Microsoft Suite Applications (Excel, Outlook, Teams).
  • Detail-oriented and good organization skills.
  • Amenable to work onsite in Makati.
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