Claims Processor – Medical Coding (Non-Voice / AUS Shift)

QBE Insurance; Cebu City; On-site; PHP 335,000 - 603,000; Full time

Job summary

QBE Insurance in Cebu City, Philippines is seeking a full-time Medical Injury Coder to review medical documents, assign AIS-based codes, and ensure accuracy within SLA timelines.

The role requires an allied medical background and experience in insurance injury coding, with strong English communication and collaboration with claims handlers.

Qualifications

• Graduates of medical allied courses, preferably Nursing or Physical Therapy.
• Experience in insurance injury coding and trauma registries.
• Experience in health or claims environments using standardized injury classifications.

Responsibilities

• Review medical reports, certificates, and hospital records to identify diagnoses and injuries.
• Assign standardized medical/injury codes (AIS or equivalent) per guidelines.
• Complete initial, review and final coding within SLA and regulatory timeframes.
• Participate in meetings to share knowledge and best practices.
• Maintain knowledge of Motor Accident Authority regulations and company guidelines.
• Liaise with internal/external networks to obtain relevant information.
• Aggregate data to identify injury type and severity in motor vehicle accidents.

Skills

Analytical Thinking

Claims Administration

Claims Resolution

Communication

Critical Thinking

Stakeholder Management

Team Collaboration

Education

Medical allied courses

Job description

• Prioritizing complex cases under SLA pressure

Primary Details

Time Type: Full timeWorker Type: Employee

Medical Coding, or Injury Coding, is a regulated and audit-exposed activity. Coding accuracy directly impacts claim outcomes, reserving, actuarial modelling, and regulatory reporting, requiring specialized skills and formal accreditation.

Primary Responsibilities

• Review and interpret medical reports, certificates, hospital records, and clinical documentation to identify relevant diagnoses and injuries
• Accurately assign standardized medical or injury codes (i.e AIS or equivalent framework) in line with regulatory and internal guidelines
• Complete initial, review and final coding within prescribed service level agreements and regulatory timeframes
• Participate in all relevant meetings in order to share and develop strategy, knowledge and best practice
• Ensure current knowledge and adherence to relevant Motor Accident Authority legislation, government and Company guidelines
• Liaise with internal and external network to obtain relevant information
• Accumulate data in order to identify the type and severity of injuries sustained in motor vehicle accidents

Required Education

• Graduates of medical allied courses preferably Nursing, Physical Therapy

Required Experience

• Insurance injury coding
• Trauma registries
• Health or claims environment using standardized injury classifications

Preferred Competencies/Skills

• Claims handling exposure
• Interpreting poorly structured and handwritten medical certificates
• Applying coding accuracy under scrutiny
• Prioritizing complex cases under SLA pressure
• Communicating coding outcomes to claims handlers and onshore stakeholders
• Excellent verbal and written communication skills (English)
• Preferably with Case Management Skills

Preferred Licenses/Certifications

• Abbreviated Injury Scale (AIS) certification is preferred but can also be taken as part of training.

Skills:

Analytical Thinking, Claims Administration, Claims Resolution, Collaboration Tools, Communication, Critical Thinking, Customer Service, Customer Value Management, Financial Advising, Intentional collaboration, Managing performance, Process Compliance, Process Improvements, Risk Management, Stakeholder Management

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.