Claim Analyst

Sun Life; Philippines; On-site; PHP 400,000 - 600,000; Full time

Job summary

Sun Life is seeking a Claims Analyst to appraise and approve life and disability claims within set limits. You will coordinate with Underwriting, Legal, and Medical inputs to determine the best course of action.

Responsibilities include handling inquiries, representing Sun Life in mediations, and conducting learning sessions for the Claims Services team. A four-year degree and strong English communication are required.

Qualifications

• Four-year degree required; medical/allied medical or legal background advantageous.
• Strong analytical, judgment, comprehension and conceptual thinking skills.
• Detail-oriented, organized and systematic; able to read and interpret laws and medical materials.

Responsibilities

• Appraise and approve death and living benefit claims within approval limits; involve Underwriting, Legal or Medical input as needed.
• Review claims beyond limits; prepare written analyses and recommended actions for Claims Manager.
• Review disbursement requests within limits and escalate beyond limits for approval.
• Handle claim inquiries from basic to complex.
• Represent Sun Life in mediations required by Insurance Commission and court hearings; participate in consultations as needed.
• Conduct learning sessions for Claims Services Section.

Skills

Analytical thinking

Judgment

Detail-oriented

Independent work

English communication

Interpersonal skills

Under pressure

Multi-tasking

Client service orientation

Team player

Willingness to study LOMA/ICA

Education

Four-year degree

Tools

MS Office

Computer literacy

Job description

Job Description:

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do.

At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful.

When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives.

Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

Appraises and approves claims within prescribed approval limits, performs initial review of claims beyond authorized approval limits and submits recommended course of action to Claims Manager.

Specific Accountabilities:

• Appraises and approves death and living benefit claims, both individual and group insurance, within approval limits. Secures Underwriting, Legal and/or Medical input where necessary.
• Appraises claims beyond authorized approval limits, prepares written analysis and recommended course of action and submits to Claims Manager for review and approval.
• Reviews and approves request within disbursement approval limits and initially reviews and submits to Claims Manager for approval those beyond disbursement approval limits.
• Attends to claim inquiries ranging from basic to complex in nature.
• Represents Sun Life in mediation required by the Insurance Commission and Court hearing, as required, involving cases appraised within approval limits.
• Conducts learning sessions for Claims Services Section, as required.

Skills and Knowledge Required:

• Graduate of any four-year course. A medical/allied medical science or legal background would be an advantage.
• Computer literate.
• Very good analytical, judgment, comprehension and conceptual thinking skills
• Detailed-oriented, organized, systematic.
• Patient and interested to read and familiarize self with provisions of the law, medical materials and review and scrutinize various documents.
• Can work independently and is decisive.
• Can work ably under pressure and can multi-task.
• With strong client service orientation and good sense of urgency.
• Possesses effective interpersonal relationship skills and is a team player.
• With above average written and verbal English communication skills.
• Willing to study and pursue required LOMA and ICA courses under Claims Career Development Program.
• With good attendance and punctuality record.

Job Category:

Claims - Life & Disability

Posting End Date:

30/12/2026