Claims Processing Specialist (Travel Insurance)
WHR Global Consulting
Negotiable
On-site - Muntinlupa
1-3 Yrs Exp
Bachelor
Full-time
Job Description
Work Setup
Onsite | Day Shift
Employment Type
Full-Time
Qualifications
- Bachelor’s degree in any related field.
- Previous experience in claims processing, customer service, or a related field is preferred.
- Strong organizational and communication skills.
- Familiarity with claims software or management systems.
- Knowledge of industry‑specific regulations and compliance standards (e.g., insurance or healthcare claims).
Key Responsibilities
- Input claim data into the system, ensuring all information is accurate, up-to-date, and properly filed.
- Assist in collecting and organizing all necessary documentation for claims, including medical reports, receipts, and forms.
- Review and assess claims to determine their validity, ensuring all necessary documentation is submitted and in compliance with relevant regulations.
- Analyze claims data to identify discrepancies, fraud, or errors and elevate complex claims to senior claims staff or managers.
- Conduct initial investigations when necessary to gather additional information or verify claims details.
- Follow up with claimants, healthcare providers, or third‑party vendors to ensure timely resolution and payment.
- Serve as a point of contact for customers or policyholders, answering inquiries related to claims status, processing timelines, and required documentation.