Claims Associate

2 days ago

Pasig, National Capital Region, Philippines UNICON Insurance and Reinsurance Brokers Corporation Full time

The Claims Associate is responsible for processing, managing, and resolving insurance claims efficiently and accurately. This role involves liaising with clients, insurers, and internal stakeholders to ensure timely and fair claims settlement while maintaining compliance with company policies and regulatory standards.

1. Claims Processing

  • Review and validate claims documentation submitted by clients to ensure completeness and accuracy.
  • Input claims data into the claims management system and maintain up-to-date records.
  • Coordinate with insurers and clients to gather additional information or clarifications needed for claims assessment.

2. Claims Assessment and Resolution

  • Analyze policy terms and conditions to determine claim coverage and eligibility.
  • Collaborate with the Claims Team Lead and insurers to resolve claims within established service-level agreements (SLAs).
  • Communicate claims decisions clearly to clients and provide guidance on next steps.

3. Client Support and Liaison

  • Serve as the primary point of contact for clients during the claims process, addressing inquiries and concerns promptly.
  • Coordinate with insurers, adjusters, and other third parties to expedite claims processing.
  • Provide updates to clients regarding the status and resolution of their claims.

4. Documentation and Reporting

  • Ensure all claims files are properly documented and filed in accordance with company policies and regulatory requirements.
  • Prepare regular claims reports and summaries for review by the Claims Team Lead and Claims Manager.
  • Identify trends or issues in claims processing and provide feedback to support process improvements.

5. Compliance and Best Practices

  • Adhere to company policies, procedures, and regulatory requirements throughout the claims process.
  • Stay updated on industry best practices, trends, and regulatory changes related to insurance claims.

Job Qualifications:

  • A graduate of a Bachelor's degree in Insurance, Business Administration or a related field.
  • At least 2–3 years of experience in insurance claims or a similar role.
  • Familiarity with insurance policies, claims processes, and regulatory standards.
  • Proficiency in claims management systems and Microsoft Office applications.
  • Strong organizational and multitasking skills.

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