Claims Operations Analyst – Commercial Insurance

4 days ago

Quezon City, National Capital Region, Philippines ECLARO Full time ₱900,000 - ₱1,200,000 per year

Role Title:
Claims Operations Analyst - Commercial Insurance
ECLARO:
A quick Summary

ECLARO is an award-winning professional services firm headquartered in New York City and operating in the U.S., Canada, UK, Ireland, Australia and the Philippines. We are dedicated to a singular purpose: providing the Right People to meet every client's needs and solve business challenges through strategic staffing, permanent placement, custom outsourcing & offshoring. Utilizing our proprietary TRINIT-E Service Maturity Model, we help clients implement programs to promote innovation, automation and process improvement.

Responsibilities & Accountabilities:

  • Intake, triage, route and assign claims to appropriate resources.
  • Comply with all regulatory requirements, company mandates and policies.
  • Prepare claims correspondence in accordance with company standards and regulatory requirements.
  • Properly document claim files, including notes and diaries, claims documents and claimant details.
  • Manage and update claims information for changes in status, parties, notifications, filings, etc.
  • Complete claims financial transactions including claim payments, vendor invoices, attorney expenses, etc.
  • Process and document returned checks, voided checks, credits, and other financial transactions.
  • Assist with the management of OFAC and other sanctions clearance on claims indemnity and expense payments.
  • Serve are primary contact for incoming calls and research and resolve inquiries promptly or escalate to the appropriate team member when necessary
  • Escalate urgent or complex matters to appropriate adjusters or supervisors
  • Support process improvements and provide feedback to enhance FNOL workflows and customer experience
  • Contribute to quality assurance and meet performance metrics for all FNOL

Ideal Candidate Profile:

  • Bachelor's degree preferred or equivalent healthcare experience.
  • Strong verbal and written communication skills required
  • Strong attention to detail and accuracy in data entry
  • 5+ years in Commercial Claims preferred or equivalent healthcare experience.
  • Preferred healthcare background in Nursing, Physician's Aid, Emergency Medical Technician and has familiarity with medical terminology used in first notices of loss.
  • Preferred previous experience in medical coding of healthcare claims.
  • Ability to exercise independent judgment and make critical business decisions effectively.

  • Claims Operations Analyst

    2 days ago

    Quezon City, National Capital Region, Philippines ECLARO Full time ₱900,000 - ₱1,200,000 per year

    Claims Operations AnalystNight ShiftOnsite in Commonwealth Ave., QCAbout the role:This position will be responsible for managing the Claims email box, meeting service level agreements, setting up the claim in ImageRight and the Claims system. Responsibilities include working directly with brokers and/or insureds for details required to complete the setup of...

  • Data Analyst/Claims

    6 days ago

    Quezon City, National Capital Region, Philippines Diversified Services Solutions Inc. Full time ₱800,000 - ₱1,200,000 per year

    We 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...

  • Claims Staff

    4 days ago

    Makati City, National Capital Region, Philippines PhilBritish Insurance Full time ₱800,000 - ₱1,200,000 per year

    Claims Staff is responsible for the efficient processing, evaluation, and settlement of insurance claims in accordance with company policies, service standards, and regulatory requirements. Ensures fair and timely claims handling to maintain client satisfaction and protect company interests.Key ResponsibilitiesReceive, record, and acknowledge policyholders'...

  • Claims Analyst

    2 weeks ago

    Makati City, National Capital Region, Philippines Pioneer Your Insurance Full time ₱300,000 - ₱600,000 per year

    YOUR 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...

  • claims manager

    2 weeks ago

    Makati City, National Capital Region, Philippines MANILA BANKERS LIFE INSURANCE CORP Full time ₱1,500,000 - ₱2,500,000 per year

    About 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 Adjuster

    4 days ago

    Makati City, National Capital Region, Philippines Pioneer Your Insurance Full time ₱1,200,000 - ₱2,400,000 per year

    Job Summary:The Claims Adjuster is responsible for investigating and processing claims for non-life insurance policies, ensuring fair and timely settlement in line with company policies and industry regulations.Job Description:Investigate and assess claims for non-life insurance lines (e.g., property, casualty, motor, liability).Conduct site inspections and...

  • Claims Assistant

    1 week ago

    Quezon City, National Capital Region, Philippines CLIMBS Life and General Insurance Cooperative Full time ₱400,000 - ₱600,000 per year

    Receive, review, and process non-life insurance claims (e.g., fire, motor, property) by validating documents and coordinating with clients or agents for compliance.Maintain accurate and updated records of claims filed, processed, and settled, ensuring proper documentation and timely reporting.Coordinate with underwriters, adjusters, and other departments to...

  • Claims Service Officer

    2 weeks ago

    Makati City, National Capital Region, Philippines FPG Insurance Full time ₱120,000 - ₱180,000 per year

    Full job descriptionBuild a career with FPG Insurance and be part of a team that creates dynamic, customer-focused insurance solutions.Our focus is on commitment and innovation across solutions for our clients, partners, shareholders, and employees alike. This focus results in the creation of an environment in which innovation, ideas, and empowerment is...

  • Claims Processor

    4 days ago

    Makati City, National Capital Region, Philippines Paramount Life & General Insurance Corp. Full time ₱900,000 - ₱1,200,000 per year

    A) Position Objective:The position is responsible for ensuring efficiency, accuracy of claims processing and settlements as part of servicing to our agents and clients insurance claims of all lines in accordance with company policies and guidelines within the accepted loss evaluation in a timely manner.B) Roles and Responsibilities:Receive and register...

  • claims manager asap

    2 days ago

    Makati City, National Capital Region, Philippines MANILA BANKERS LIFE INSURANCE CORP Full time $104,000 - $130,878 per year

    About 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...