Claims Assistant (Open to Fresh Graduates)

MoneeInsure Philippines; Mandaluyong; On-site; PHP 240,000 - 360,000; Full time

Job summary

MoneeInsure Philippines is seeking a detail-oriented Claims Evaluation Specialist to review and process insurance claims, ensuring accuracy and timely payouts.

You will work with Bytesforce or similar CRM, assess coverage, detect potential fraud, and collaborate with Product and QA teams to optimize claims systems and processes. Fresh graduates are welcome to apply, with a Bachelor’s degree in Finance, Commerce, or allied fields, and a track record of meticulous documentation review.

Qualifications

• Bachelor's degree in Finance, Commerce, Allied Medical or related field.
• Demonstrated ability to review documents for accuracy and completeness.
• Fresh graduates welcome to apply, with relevant internship experience preferred.

Responsibilities

• Evaluate and process insurance claims with accuracy and timely payouts.
• Review documentation and assess coverage and liability.
• Determine legitimacy of claims and detect potential fraud.
• Calculate claim payouts and ensure correct processing.
• Coordinate with Product Management for system enhancements and support QA/UAT.
• Identify opportunities to optimize operational processes and improve user experience.

Skills

Attention to detail

Analytical thinking

Communication

Team collaboration

Education

Bachelor's degree in Finance/Commerce/Allied Medical

Tools

Bytesforce CRM

Job description

Monee is a part of Sea Group, a leading global consumer internet company. Monee’s mission is to better the lives of individuals and businesses in our region with financial services through technology. Monee’s offerings include mobile wallet services, payment processing, credit offerings, and related digital financial services and products. These are available in seven markets across Southeast Asia and Taiwan under various brands, including ShopeePay, SPayLater, and other brands.

Job Description:

This role evaluates and processes insurance claims accurately by reviewing documentation, assessing coverage, and detecting potential fraud while ensuring timely payouts. This role collaborates with product and cross-functional teams to enhance claims systems, support testing efforts, and drive continuous operational improvements for an optimized user experience.

Claims Evaluation and Processing

Utilize our CRM system as the primary system for claims management and processing.

Review and assess claims documentation for accuracy and completeness.

Analyze coverage and liability based on policy terms and conditions.

Determine the legitimacy of claims and identify potential fraudulent activities.

Calculate claim payouts and ensure timely and accurate processing of claims.

System Enhancement and Coordination

Coordinate with the Product Management Team to suggest Bytesforce system enhancements for claims processes

Support quality assurance and user acceptance testing (UAT) efforts, working with relevant stakeholders to align with system and customer requirements.

Operational Optimization

Work alongside business and cross-functional teams to constantly optimize operational processes and improve the product experience for both internal and external users.

Identify and suggest opportunities for process improvements and increased efficiency.

Requirements:

Bachelor's Degree (Finance, Commerce, Allied Medical); Fresh graduates are welcoming to apply

Proven experience in claims evaluation and processing, with strong skills in reviewing documentation for accuracy and completeness

Proficient in utilizing CRM systems (preferably Bytesforce or similar) for claims management and processing