Claims Analyst- Ortigas,Mandaluyong
5 days ago
Monee is a part of Sea Group, a leading global consumer internet company. Monee's mission is to better the lives of individuals and businesses in our region with financial services through technology. Monee's offerings include mobile wallet services, payment processing, credit offerings, and related digital financial services and products. These are available in seven markets across Southeast Asia and Taiwan under various brands, including ShopeePay, SPayLater, and other brands.
Job Description:
Claims Evaluation and Processing
- Utilize our CRM system as the primary system for claims management and processing.
- Review and assess claims documentation for accuracy and completeness.
- Analyze coverage and liability based on policy terms and conditions.
- Determine the legitimacy of claims and identify potential fraudulent activities.
- Calculate claim payouts and ensure timely and accurate processing of claims.
System Enhancement and Coordination
- Coordinate with the Product Management Team to suggest Bytesforce system enhancements for claims processes
- Support quality assurance and user acceptance testing (UAT) efforts, working with relevant stakeholders to align with system and customer requirements.
Operational Optimization
- Work alongside business and cross-functional teams to constantly optimize operational processes and improve the product experience for both internal and external users.
- Identify and suggest opportunities for process improvements and increased efficiency.
Requirements:
- A Bachelor's Degree in Finance, Commerce or any medical field
- Minimum of 1 year of experience in a Life / general Insurance firm.
- Good understanding of the local life and health insurance product market.
- Understanding of health-related claims and overall Filipino health service systems (i.e. public / private healthcare, clinics, other providers) network
- Good understanding of local regulatory requirements, particularly from a claims perspective
Job Type: Full-time
Application Question(s):
- Availability for the interview.
- Are you okay for a hybrid set-up? (4xa week onsite and once a week WFH)
- How much is your asking salary?
Work Location: In person
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