Claims Evaluator

Pioneer Your Insurance; Makati; On-site; PHP 300,000 - 420,000; Full time

Job summary

Pioneer Your Insurance in Makati, Philippines, is seeking an experienced Claims Reviewer to review and approve claims within the assigned scope. You will maintain strong communication with clients and internal teams, and support enhancements to the review system while keeping organized filing for claims.

The role requires a bachelor’s degree in Business Management, Medical, or Communications, proficiency in MS Office, readiness for fieldwork, and at least 3 years of experience in processing

Qualifications

• Bachelor’s degree in Business Management, Medical or Communications is required.
• Proficient in MS applications and office software.
• Willingness to perform fieldwork and travel as needed.
• At least 3 years of experience in processing insurance claims.

Responsibilities

• Reviews and approves claims within the assigned scope.
• Maintains effective communication and good relationships with clients and internal units.
• Suggests enhancements to claims review processes reflecting market trends.
• Implements system enhancements in the assigned area.
• Maintains a filing system for claims review and approval.
• Prepares claims reports to monitor loss performance.
• Reviews letters of denial.

Skills

Communication

Coordination

Claims processing

Education

Bachelor's degree in Business Management, Medical, or Communications

Tools

MS Applications

Job description

Job Role

• Reviews and approves claims within the assigned scope

• Maintains effective communication, coordination and good relationship with clients, concerned business units and other parties involved in claims review process

• Recommends enhancements in theclaims review and approval system andprocedures to reflect current Microinsurance market trends

• Implements approved enhancement of systems in the assigned area

• Maintains a filing system for claims review and approval

• Helps prepare claims reports to monitor the loss performance of Microinsurance

• Reviews letter of denial

Qualifications

• Graduate of bachelor's degree course - Business Management, Medical or Communications

• Proficient in MSapplications

• Amenable to fieldwork

• At least 3 years' experience in processing insurance claims