Claims Processing Manager

4 days ago


Makati City, National Capital Region, Philippines Manulife Full time

About the Role:

We are seeking a highly skilled and experienced Sr. Health Claims Analyst to join our team. The successful candidate will be responsible for reviewing and assessing claims, ensuring accurate benefit payouts, and maintaining compliance with policy details, laws, and regulations.

Key Responsibilities:

  • Conduct thorough analysis of claims and determine eligibility for benefits.
  • Make informed adjudication decisions and provide recommendations within prescribed approval limits and turnaround times.
  • Collaborate with the Third-Party Administrator (TPA) to review and approve recommendations and decisions.
  • Maintain accurate and up-to-date records of claims, communications, and resolutions in the claims management system.

What We Offer:

  • A competitive salary and comprehensive benefits package.
  • A collaborative and dynamic work environment.
  • Opportunities for professional growth and development.

Our Values:

  • Customer obsession: We put our customers at the forefront of everything we do.

  • Innovative thinking: We encourage creativity and out-of-the-box solutions.

  • Teamwork: We believe in collaboration and working together towards a common goal.

  • Integrity: We operate with honesty and transparency in all aspects of our business.

  • Social responsibility: We prioritize diversity, equity, and inclusion, and strive to make a positive impact on society.



  • Quezon City, National Capital Region, Philippines P and I Claims Management Inc. Full time

    We are looking for an experienced Claims Resolution Manager to join our team at P and I Claims Management Inc.The ideal candidate will have a strong background in insurance claims, excellent analytical skills, and the ability to work well under pressure.Responsibilities include analyzing claims, evaluating evidence, and making recommendations on...


  • Quezon City, National Capital Region, Philippines P and I Claims Management Inc. Full time

    P and I Claims Management Inc. is seeking an Insurance Claims Director to lead our claims management team.The successful candidate will have extensive experience in insurance claims, excellent leadership skills, and the ability to make strategic decisions.Key responsibilities include managing claims teams, analyzing claims data, and developing strategies to...


  • Makati City, National Capital Region, Philippines Allianz Popular SL. Full time

    Job OverviewThe Claims Officer is responsible for processing medical claims for clients in their assigned region. This involves examining and processing claims accurately and efficiently, ensuring compliance with company policies and procedures.The ideal candidate will have strong analytical and problem-solving skills, as well as excellent communication and...


  • Makati City, National Capital Region, Philippines Eteam Workforce Private Corporation Full time

    Job Overview:The Insurance Triage Coordinator position at Eteam Workforce Private Corporation requires a detail-oriented individual with excellent organizational skills. In this role, you will be responsible for triaging claims documents, conducting pre-adjudications, and ensuring accurate data entry.Main Responsibilities:Triage claims documents upon...


  • Mandaluyong City, National Capital Region, Philippines RelianceUnited Full time

    **Job Requirements:**We are looking for a detail-oriented Claims Processing Specialist to join our team at RelianceUnited. As a key member of our healthcare operations, you will be responsible for processing claims reconciliation requests from accredited Flexicare network providers.**Key Responsibilities:**Process claims records from accredited hospitals and...

  • Claims Officer

    21 hours ago


    Makati City, National Capital Region, Philippines Allianz Popular SL. Full time

    BENEFITSPerformance Incentive Plan / Yearly BonusRetirement Program and Group Life InsuranceHybrid Work Set-up after 6 months of employmentBe part of a pioneer teamJOB DETAILS / ROLE PURPOSEThe role of Claims Officer involves processing medical claims for clients in their assigned region. We ensure a high level of client service while processing claims...


  • Makati City, National Capital Region, Philippines Eteam Workforce Private Corporation Full time

    Job Summary:We are seeking a highly skilled Senior Claims Specialist to join our team at Eteam Workforce Private Corporation. In this role, you will be responsible for managing claims documents, conducting pre-adjudications, and recording data in our claims masterfile tracker.Key Responsibilities:Receive and process claims documents from various...


  • Makati City, National Capital Region, Philippines Trinity Workforce Solutions Full time

    The role involves managing claims administration by preparing and sending advisories, updating trackers, monitoring outstanding balances, and performing administrative tasks to ensure efficient claims processing and communication.


  • Makati City, National Capital Region, Philippines Allianz Popular SL. Full time

    Job DescriptionThe role of Claims Officer at Allianz Popular SL involves processing medical claims for clients in their assigned region. We ensure a high level of client service while processing claims within an industry leading 48 hours.The position requires the ability to examine and process claims accurately and efficiently, ensuring compliance with...


  • Quezon City, National Capital Region, Philippines Arch Insurance Full time

    OverviewThe Claims Administrator is responsible for the triaging, identification and allocation of incoming claims related correspondence and assisting the Claims team as required with tasks including, but not limited to, processing reinsurance claims, claims reporting, and document management.ResponsibilitiesAnalyze initial claim notifications, including...

  • Claims Coordinator

    2 weeks ago


    Makati City, National Capital Region, Philippines Hunter's Hub Inc. Full time

    Job Qualifications:• Must have an experience in processing life insurance claims, adjudicating health or life claims for 2 years and up.• Must be a bachelors degree holder of Finance, Administration or any related• Familiarity with basic regulations governing the insurance industry, including data privacy, anti-bribery and corruption laws.• Strong...


  • Quezon City, National Capital Region, Philippines Nabati Philippines Full time

    Key Responsibilities:Receiving all marketing-related activities claims from the branchEnsuring that all marketing claims are properly documented with the Sales & Operations DepartmentPreparing and clearing all marketing claims with Account Receivables in the systemAligning the Marketing Budget Program, Accrual & Actual Expenses with the Finance & Accounting...


  • Makati City, National Capital Region, Philippines Manulife Full time

    About the OpportunityThe role of Senior Health Claims Analyst is a critical position within our organization, responsible for reviewing and assessing claims to ensure accurate benefit payouts and adherence to policy details, laws, and regulations.Key Responsibilities:Determine eligible benefits based on submitted documents and policy provisions.Adjudicate...


  • Makati City, National Capital Region, Philippines Manulife Full time

    Job Description Summary:The Sr. Health Claims Analyst will play a key role in reviewing and assessing claims, ensuring accurate benefit payouts, and maintaining compliance with policy details, laws, and regulations.Key Job Responsibilities:Analyze and determine eligible benefits based on submitted documents and policy provisions.Make adjudication decisions...


  • Quezon City, National Capital Region, Philippines P and I Claims Management Inc. Full time

    P and I Claims Management Inc. is seeking a highly skilled Risk Management Specialist to join our team.The successful candidate will analyze and evaluate claims based on relevant documents to determine their validity and establish liability.Key responsibilities include preparing reports for the Head of Operations, negotiating settlements, and attending...


  • Makati City, National Capital Region, Philippines Hunter's Hub Inc. Full time

    About the RoleThe ideal candidate will have a bachelor's degree in Finance, Administration, or a related field and at least 2 years of experience in processing life insurance claims, adjudicating health or life claims.Key responsibilities include:Drafting settlement, decision, and temporary closure letters.CHUB encoding.Monitoring first and second pending...


  • Makati City, National Capital Region, Philippines Manulife Full time

    The opportunityThis Sr. Health Claims Analyst is responsible for the overall review, assessment, and decision of claims.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...


  • Makati City, National Capital Region, Philippines UnitedHealth Group Full time

    UnitedHealth Group is seeking a Medical Claims Resolution Associate to join our team. In this role, you will be responsible for resolving medical claims disputes and ensuring timely resolution for our customers. You will work closely with cross-functional teams to identify root causes of issues and implement effective solutions.Main Responsibilities:Analyze...


  • Quezon City, National Capital Region, Philippines Intogreat Solutions Full time

    About the RoleWe are seeking a highly skilled Vehicle Claims Specialist to join our team. As a specialist in this field, you will be responsible for assessing and managing vehicle claims from initial reporting to final resolution.Key Responsibilities:Conduct thorough assessments of damaged vehicles to determine extent of damage and cost of repairs.Develop...

  • Claims Analyst

    1 week ago


    Quezon City, National Capital Region, Philippines ECLARO Full time

    ECLARO Quezon City, National Capital Region, PhilippinesClaims AnalystECLARO Quezon City, National Capital Region, Philippines3 days ago Be among the first 25 applicantsRole Title: Claims AnalystECLARO: A quick SummaryECLARO is an award-winning professional services firm headquartered in New York City and operating in the U.S., Canada, UK, Ireland, Australia...