Claims Evaluation Senior Assistant

Pioneer Insurance; Taguig; On-site; PHP 446,000 - 725,000; Full time

Job summary

Pioneer Insurance in the Philippines is seeking a claims reviewer to evaluate and approve motor and property claims within the assigned authority, applying insurance principles and company guidelines to determine liability. The role includes reviewing drafts of Offer Letters and Denial Letters, ensuring the claims log is complete, and maintaining strong communication with clients and internal units.

Candidates should have a business degree and at least two years of experience in evaluating and

Qualifications

• Graduate of business course.
• At least 2 years experience in evaluating (approval and denial) trad motor and property claims.
• Proficient in the use of Microsoft Applications, keen with details and can deliver under strict deadlines.
• Amenable to loop to other claims teams handling Microinsurance claims as part of secondary tasks.
• At least 2 yrs experience in approving trad motor and property claims.

Responsibilities

• Reviews and approves claims within the assigned scope/level of authority and standard turnaround time by identifying all relevant information/issues, establishing connection among gathered facts and application of insurance principles, insurance compliance requirements, company guidelines, and policy details to determine liability.
• Reviews and approves the drafts of Offer Letter or Letter of Authority, Order of Payment and Denial Letter.
• Ensures that claims log sheet is complete and updated.
• Maintains effective communication, coordination, and good relationship with clients, concerned business units, and other parties involved in the claims review process.
• Recommends enhancements in the claims review and approval system and procedures to reflect current Microinsurance market trends.

Skills

Microsoft Office

Detail oriented

Deadline driven

Team collaboration

Motor & property claims experience

Education

Business degree

Job description

• Reviews and approves claims within the assigned scope/level of authority and standard turnaround time by identifying all relevant information/issues, establishing connection among gathered facts and application of insurance principles, insurance compliance requirements, company guidelines, and policy details to determine liability.
• Reviews and approves the drafts of Offer Letter or Letter of Authority, Order of Payment and Denial Letter.
• Ensures that claims log sheet is complete and updated.
• Maintains effective communication, coordination, and good relationship with clients, concerned business units, and other parties involved in the claims review process.
• Recommends enhancements in the claims review and approval system and procedures to reflect current Microinsurance market trends.

Qualifications:

• Graduate of business course.
• At least 2 years experience in evaluating (approval and denial) trad motor and property claims.
• Proficient in the use of Microsoft Applications, keen with details and can deliver under strict deadlines.
• Amenable to loop to other claims teams handling Microinsurance claims as part of his secondary tasks.
• At least 2 yrs experience in approving trad motor and property claims