Claims Examiner

5 days ago

Philippines Combined Insurance Full time ₱900,000 - ₱1,200,000 per year

ey Responsibilities:

  1. Process claims document and index to appropriate claims files in the system.

  2. Responsible for FNOL (First Notice of Loss)/ new claim files creation and registration in the system including policy verification/ upload of policy documents and determination of appropriate coverage.

  3. Ensures loss reserves are set and maintained with timely updates of claims data into our systems, ensuring correctness of systems and file records

  4. Review claim files and manage proper triage allocation:

  5. To appropriate Claims Work Queue by claims type and coverage

  6. To appropriate Claims Team by complexity (simple/ complex)

  7. To appropriate Claims Department (Complaints, Recovery, Fraud)

  8. Manage and assess claims (Fast Track, Within HFC Threshold, and Simple) from end to end including settlement in the system, responding to customer queries, providing updates, and requesting additional information as needed.

  9. Prepares and sends written correspondences (e.g. Acknowledgment, Settlement etc.) to brokers, claimants and others as required.

  10. Attend to claims enquiries and feedback, maintain positive relationship with all customers, brokers, providers etc.

  11. Handles incoming and outbound queries from Customers and/ or Brokers.

  12. Proactively apply claims policies and procedures including Chubb's policy in relation to fraud, salvage, recovery, cost containment and complaints.

  13. Attends administrative activities (team huddles, trainings)

  14. Performs other related duties as may be assigned by the supervisor/s

  15. Immediately report potentially and confirmed Fraudulent cases, Compliance and Privacy Breaches to Management chain.

  16. Nominate two process improvement ideas annually for SME and TL endorsement to the Manager.

Experience:

  • Good analytical skills and strong attention to detail.
  • Demonstrated strong communication skills (written and verbal) and interpersonal skills to be capable of dealing with all levels of Chubb personnel as well as claimants and brokers.
  • Ability to organize work effectively and methodically and as a team and adjust to change driven by business needs.
  • Ability to maintain a high level of quality in all claims administration activities ensuring the settlement times and complaint levels are minimized.
  • Sound knowledge of claims administration procedures and related systems.
  • Possess strong customer service behaviour.

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