Claims Analyst

13 hours ago

Taguig, National Capital Region, Philippines PRINCIPAL GLOBAL SERVICES (PHILIPPINES) LLC Full time ₱900,000 - ₱1,200,000 per year

Benefits:

HMO up to 3 dependents for free

15% night diff (10pm-6am)

Annual Appraisal

Performance Bonus

Retirement Benefit

Fixed Weekends Off

PHRN license allowance

Responsibilities:

As an Accident ClaimsAnalyst in this fast-paced environment, every single day offers new challenges and the ability to use excellent analytical, multitasking, prioritization, and interpersonal skills to assist with clients' Accident Claims.

  • Acquire, analyze, and investigate medical, financial and contractual information to make effective and timely claim decisions.
  • Connect with employers, employees and medical providers via phone, email, text, and letters.
  • Provide customers with updates regarding medical conditions, restrictions & limitations, job duties, group short term disability policy provisions, claim decisions, status, and all other aspects of the claim process to ensure they fully understand the company's position.
  • Supervise and follow up on outstanding items to ensure compliance with regulations, service timing, and quality guidelines.

Qualifications:

  • PHRN with Claims Experience
  • Claim Processing Experience – reviewing and gathering information, making phone calls, and making the actual claim decision.
  • Legal and policy experience - being able to read, interpret policies, policy provisions and industry regulations to accurately interrupt and apply them to claims situations is preferred.
  • Basic math skills.
  • Ability to actively listen while you collect information on the telephone and provide strong customer service, providing empathy to the customers going through tough situations.
  • Ability to accept & apply feedback.
  • Ability to maintain a high degree of accuracy, pay strict attention to detail, maintain confidentiality, and work within the grey.
  • Excellent analytical, interpersonal, problem solving, decision-making, and multi-tasking skills.
  • Computer skills and typing proficiency – Microsoft Outlook, Word, Excel experience is preferred.
  • Work independently as well as in a team environment.

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