Claims Specialist

8 hours ago

Taguig, National Capital Region, Philippines WHR Global Consulting Full time ₱104,000 - ₱130,878 per year
  • Position
    : Claims Assistant (Non-motor Insurance)
  • Location
    : Alabang, Muntinlupa City
  • Setup
    : Onsite
  • Schedule
    : Day Shift

Qualifications:

  • Graduate of any 4-year bachelor's degree.
  • 2 – 4 years of experience in Non-Motor Claims or prior experience in a claims department or working with insurance claims is a significant advantage.
  • Experience in handling properties, cargo, and OFW-related accounts.
  • Prior administrative or customer service experience in insurance, healthcare, or financial services.
  • Proficient in Microsoft Office Suite (Excel, Word, etc.) and familiar with claims management software.
  • Strong communication skills, both written and verbal.
  • Ability to handle confidential information with discretion.
  • Team-oriented and proactive in assisting other claims staff.

Responsibilities:

  • Input claim data into the system, ensuring accuracy, completeness, and proper filing.
  • Assist in collecting and organizing necessary documentation for claims, including medical reports, receipts, and forms.
  • Analyze claims data to identify discrepancies, fraud, or errors and escalate complex claims to senior staff or managers.
  • Conduct initial investigations to gather additional information or verify claim details when necessary.
  • Assist in negotiation or determination of appropriate settlements within guidelines.
  • Follow up with clients, healthcare providers, or third parties to ensure documentation is received for timely claim resolution.
  • Communicate with clients, vendors, adjusters, and internal departments for information requests or clarifications.
  • Answer inquiries from claimants or policyholders regarding claim status, documentation, and timelines; provide updates as needed.
  • Maintain accurate and organized physical or electronic files for each claim.
  • Ensure compliance with industry regulations, company policies, and procedures related to claims.
  • Provide general administrative support such as scheduling meetings and preparing claim-related reports.
  • Assist in preparing reports on claims processing performance or trends for management.

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