Claim Analyst

Sunlife Solar; Taguig; On-site; PHP 500,000 - 700,000; Full time

Job summary

Sun Life in the Philippines is seeking a Claims Analyst for Life & Disability to appraise and approve claims within limits, coordinating with Underwriting, Legal, and Medical input as needed. You will handle inquiries, participate in mediations, and contribute to ongoing training for the Claims Services team.

The role requires strong analytical skills, meticulous attention to detail, and the ability to work independently under pressure while delivering client-focused service.

Qualifications

• Graduate of any four-year course.
• 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.

Responsibilities

• Appraises and approves death and living benefit claims within approval limits; secures inputs as needed.
• Appraises claims beyond approved limits, writes analysis, submits to Claims Manager.
• Reviews and approves disbursement requests within limits; forwards beyond limits to manager.
• Handles claim inquiries from basic to complex.
• Represents Sun Life in mediation and court hearings when required.
• Conducts learning sessions for Claims Services Section.

Skills

Analytical thinking

Judgment

Attention to detail

English communication

Independent work

Multi-tasking

Client service

Education

Four-year degree

Medical/Legal background advantageous

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