Claims Specialist

InLife Benefits Insurance Company, Inc.; Cebu City; On-site; PHP 240,000 - 400,000; Full time

Job summary

InLife Benefits Insurance Company, Inc. in Cebu City is seeking a detail-oriented Claims Processor to join our team.

You will review and process insurance claims, verify coverage, communicate with claimants and providers, and coordinate with underwriters to ensure accurate handling. The ideal candidate has a bachelor’s degree, familiarity with claims processing, strong organizational and communication skills, and proficiency in claims management software and MS Office.

Qualifications

• Graduate with any bachelor’s degree.
• Experience in claims processing or insurance preferred.
• Understanding of insurance policies and claims procedures.
• Strong attention to detail and organizational skills.
• Effective communication and customer service.
• Ability to work independently and as part of a team.
• Proficiency with claims management software and MS Office.

Responsibilities

• Receive, review, and process insurance claims submitted by policyholders.
• Verify claim information and assess coverage according to policy terms.
• Communicate with claimants, healthcare providers, and other relevant parties to gather necessary documentation.
• Investigate claims by reviewing evidence and coordinating with adjusters as needed.
• Determine claim validity and recommend approval or denial based on findings.
• Prepare and maintain accurate records and reports related to claims.
• Resolve customer inquiries and concerns related to claims promptly and professionally.
• Collaborate with underwriting, legal, and finance teams to ensure proper claim handling.
• Ensure compliance with company policies, procedures, and regulatory requirements.
• Support continuous improvement initiatives to enhance claims processing efficiency.

Skills

Attention to detail

Communication

Teamwork

Independent work

Education

Bachelor's degree

Tools

Claims management software

Microsoft Office

Job description

Key responsibilities

• Receive, review, and process insurance claims submitted by policyholders
• Verify claim information and assess coverage according to policy terms
• Communicate with claimants, healthcare providers, and other relevant parties to gather necessary documentation
• Investigate claims by reviewing evidence and coordinating with adjusters as needed
• Determine claim validity and recommend approval or denial based on findings
• Prepare and maintain accurate records and reports related to claims
• Resolve customer inquiries and concerns related to claims promptly and professionally
• Collaborate with underwriting, legal, and finance teams to ensure proper claim handling
• Ensure compliance with company policies, procedures, and regulatory requirements
• Support continuous improvement initiatives to enhance claims processing efficiency

About you

• Graduate of any bachelor's degree
• Previous experience in claims processing or insurance preferred
• Good understanding of insurance policies and claims procedures
• Strong attention to detail and organizational skills
• Effective communication and customer service skills
• Ability to work independently and as part of a team
• Proficiency with claims management software and Microsoft Office application