Claims Evaluator

Job PurposeThe Claims Evaluator/Examiner is responsible for investigating, evaluating, and processing non-life insurance claims in accordance with company policies, procedures, and regulatory requirements. The role ensures timely, fair, and accurate settlement of claims while maintaining excellent customer service and minimizing company losses.Roles and...

YOUR ROLEVerification of cover in order to determine if indeed there is coverage/policy in-force when the loss occursMakes the necessary recommendation on a claim (such as for final action or to require further documents or information) or makes a final decision on claim, in accordance with the claim's authorityHandles the necessary communication that should...

Oversee the entire Claims Department, ensuring efficient processes, timely settlements, and accurate reporting.Manage, investigate, and negotiate claims, ensuring fair insurer decisions and high-quality service for clients.Act as escalation point for complex cases, resolve disputes professionally, and represent the company in meetings with insurers and...

OVERVIEWReview and evaluate claim fairly and promptly, from registration to payment to Insured, third parties and service providers, in compliance to Policies, Regulations and Guidelines set by the company.Job Description:Register claims, book its loss reserves and send loss advices to reinsurers.Review, evaluate/re-evaluate, recommend claim, establish its...

Must possess any medical-related field degree;With HMO experience is an advantage but not required;Reviews insurance claims for accuracy and completeness;Verify policy details and coverage;Investigate claims by gathering necessary information from claimants, witnesses, and other relevant parties.;Evaluate claims based on policy provisions and determine the...

FPG Insurance has built an enviable reputation for developing customer insights that support the creation of relevant commercial and individual insurance products and solutions.What you'll do:Responsible in performing pre-evaluation to determine the compensability/liability of a claimDetermines the sufficiency of the submitted documents includes validation...

Established in 1999, AXA Philippines is one of the largest and fastest growing life insurance companies in the country. It offers financial security to more than one million individuals through its group and individual life insurance as well as general insurance products through its subsidiary Charter Ping An. AXA Philippines is one of the first to introduce...

Provider Dispute Claims Processor | Urgent HiringWork Set-Up: In-Office Training Required | Potential for Remote Work After TrainingLocation: Makati, ValeroExpected Start Date: December 8, 2025Position Summary:We are seeking an experienced Provider Dispute Claims Processor to join our growing healthcare team. This role is responsible for reviewing,...

Work Set-Up: In-Office Training Required | Potential for Remote Work After TrainingLocation: Makati, ValeroExpected Start Date: December 8, 2025Position Summary:We are seeking a dynamic and experienced Healthcare Claims Adjudication Lead to oversee our growing healthcare team. This role is pivotal in ensuring timely, accurate, and compliant processing of...

Work Set-Up: In-Office Training Required | Potential for Remote Work After Training)Location: Makati, ValeroExpected Start Date: December 8, 2025Your next career move starts here – submit your application todayPosition Summary:We are seeking an experienced Provider Dispute Claims Processor to join our growing healthcare team. This role is responsible for...