Claims Processing Lead & Mentor (On-site)

WHR Global Consulting; Muntinlupa; On-site; PHP 334,800 - 580,320; Full time

Job summary

WHR Global Consulting in Muntinlupa, on-site, is seeking an experienced Claims Processor with 3-5 years in claims processing. The role focuses on accurate review, documentation verification, and timely processing of claims in line with company policies.

The ideal candidate holds an Associate's or Bachelor's degree, proficient in claims software and Microsoft Office, and can mentor junior staff while ensuring quality and regulatory compliance.

Qualifications

• Associate’s or Bachelor’s degree in a related field is a plus.
• 3–4 years of experience in claims processing or a related field.
• Advanced knowledge of claims processing software and Microsoft Office Suite.
• Strong organizational and multitasking abilities to manage claims.
• Excellent communication and problem-solving skills.
• Ability to work under pressure and meet deadlines while maintaining accuracy.
• Leadership skills with mentoring or supervising junior staff.
• Strong attention to detail and accuracy in claims documentation.

Responsibilities

• Claims Review & Assessment: handle complex or high-priority claims with complete documentation.
• Claims Processing: process claims within timelines with appropriate outcomes.
• Claims Settlement: assist in determining settlements or payouts per guidelines.
• Escalation Management: handle escalated claims and provide SME guidance.
• Problem Resolution: identify and resolve discrepancies in claims processing.
• Quality Assurance: review data and ensure accuracy of claims entered.
• Follow-up: obtain missing documentation from clients and providers.
• Compliance & Adherence: ensure processing follows policies and regulations.
• Claims Coordination: work with Adjusters, Managers, and other departments.
• Team Leadership & Mentorship: mentor junior staff and assist onboarding.
• Claims Reporting: generate and review status reports for management.
• Administrative Support: prepare documentation, reports, and schedules.
• Process Improvement: suggest and implement workflow improvements.
• Claims Data Management: maintain accurate records and generate performance reports.

Skills

Claims software

Microsoft Excel

Organizational skills

Communication skills

Attention to detail

Leadership

Education

Associate’s or Bachelor’s degree (related field)

Tools

Claims processing software

Job description

WHR Global Consulting in Muntinlupa, on-site, is seeking an experienced Claims Processor with 3-5 years in claims processing. The role focuses on accurate review, documentation verification, and timely processing of claims in line with company policies.

The ideal candidate holds an Associate's or Bachelor's degree, proficient in claims software and Microsoft Office, and can mentor junior staff while ensuring quality and regulatory compliance.