Insurance and Medical Claims Specialist

8 hours ago

Manila, National Capital Region, Philippines MOXI Global Corporation Full time $40,000 - $60,000 per year

MUST:

  • Candidates should have at least 2 years of insurance agency or broker experience.
  • Must be an advanced user of Microsoft Excel and CRM tools.
  • Must have experience in any of the following: Claims Management / Claims Processing/ Insurance Claims / Medical Claims Review
  • Must have knowledge about State Workers' Compensation Laws

The position manages and maintains workers' compensation policies for assigned clients, ensuring compliance, timely renewals, accurate invoicing, and proper classification codes. This role involves updating CRM systems, submitting payroll reports, and supporting audits and internal teams. Familiarity with US workers' compensation policies a must.

Essential Duties:

  • Oversees the administration of workers' compensation policies including monopolistic state policies.
  • Ensures administered policies remain in force and in good standing.
  • Updates the customer relationship management system with all workers' compensation policy information for assigned clients.
  • Ensures tasks are created/current for each assigned client in the customer relationship management system.
  • Submits payroll reports to carriers as required per the terms of each policy.
  • Ensures all premium invoicing is completed each month in a timely fashion.
  • Submits needed policy changes to the broker/carrier.
  • Works with auditors to complete all required policy audits.
  • Ensures all assigned policies are renewed timely.
  • Responsible for ensuring class codes are proper for all assigned policies.
  • Assists with the cancellation of workers' compensation policies when needed.
  • Assists the payroll department in addressing payroll system errors relating to administered workers' compensation policies.

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