Senior Claims Analyst Lead

4 days ago


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 and provide recommendations within prescribed approval limits and turnaround times.
  • Collaborate with the Third-Party Administrator (TPA) to review and approve recommendations and decisions.
  • Manage accurate records of claims, communications, and resolutions in the claims management system.

Requirements:

  • Minimum 3 years of experience in life and health claims processing, insurance, or a related field.
  • Bachelor's degree in healthcare administration, business, or a related field (preferred).
  • Industry certifications or exams passed (FLMI, etc.).

Benefits:

  • A competitive compensation package.
  • A dynamic and supportive work environment.
  • Opportunities for professional growth and development.


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