Claims Specialist: Fast-Track Processing & Team Coaching

Raffles Medical Group Ltd; Santo Niño 1st; On-site; PHP 201,000 - 290,000; Full time

Job summary

Raffles Medical Group Ltd. is seeking a detail-oriented claims processor to review and process insurance claims in line with policy contracts and guidelines. The role emphasizes accuracy, timely settlements, and strong customer service within a fast-paced environment.

You will coordinate with junior staff, manage inquiries, and participate in system enhancements and IT discussions to improve processes. Diploma holders with 1 year of related experience are encouraged to apply.

Qualifications

• Diploma holder with at least 1 year of related work experience.
• Proficient in Microsoft Office applications (Excel, Word, PowerPoint).
• Insurance industry experience preferred, especially Group Insurance products.
• Able to work independently and adapt quickly.
• Able to multi-task and meet tight deadlines in a fast-paced environment.
• Strong customer orientation and team player.

Responsibilities

• Review and process claims in accordance with policy contracts and guidelines.
• Ensure claim settlements are concluded within the agreed Turnaround Time (TAT).
• Check data entry to ensure minimum errors and accuracy.
• Verify claims/reports prepared by junior staff for accuracy.
• Manage emails and telephone inquiries in a timely manner per KPI.
• Coordinate with medical institutions for medical reports and Letter of Guarantee issuance.
• Analyze workflows and streamline processes for efficiency.
• Coach and train junior staff.
• Embrace technology and participate in IT discussions/UAT testing.
• Undertake other projects as assigned.

Skills

Multi-tasking

Team player

Fast learner

Customer focus

Education

Diploma holder (1 year experience)

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Job description

Raffles Medical Group Ltd. is seeking a detail-oriented claims processor to review and process insurance claims in line with policy contracts and guidelines. The role emphasizes accuracy, timely settlements, and strong customer service within a fast-paced environment.

You will coordinate with junior staff, manage inquiries, and participate in system enhancements and IT discussions to improve processes. Diploma holders with 1 year of related experience are encouraged to apply.