Claim Analyst

sunlife; Philippines; On-site; PHP 350,000 - 550,000; Full time

Job summary

Sun Life Philippines seeks a claims professional to appraise and approve life and disability claims within authorized limits. You will obtain input from medical, legal, and underwriting teams as needed and prepare actions for managerial review.

The role handles inquiries, represents the company in mediations, and leads learning sessions for the Claims Services Section, requiring strong analytical and English communication skills.

Qualifications

• Graduate of any four-year course; a medical/allied medical science or legal background would be an advantage.
• Computer literate and proficient in English communication.

Responsibilities

• Appraises and approves death and living benefit claims within approval limits; secures input from Underwriting, Legal, and/or Medical as needed.
• Appraises claims beyond approved limits; prepares written analysis and submits to Claims Manager for review.
• Reviews and approves requests within disbursement limits and submits beyond limits to Claims Manager for approval.
• Handles claim inquiries ranging from basic to complex in nature.
• Represents Sun Life in mediation required by the Insurance Commission and Court hearings, as required.
• Conducts learning sessions for Claims Services Section.

Skills

Analytical thinking

Judgment

English communication

Team player

Independent worker

Multitasking

Client service orientation

Interpersonal skills

Education

Four-year degree

Medical/allied medical science or legal background advantageous

Tools

Computer literate

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