CRM Claims Process Admin

Smartsourcing Inc.

Cebu City

On-site

PHP 290,000 - 424,000

Full time

8 days ago

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Benefits offered by this job

5-day Christmas Leave

Healthcare from Day 1

Free lunch and barista coffee

Night shift differential

Gym membership subsidies

Community workshops

Job summary

Smartsourcing is hiring a full-time onsite CRM Claims Process Administrator in Cebu City to manage claim submissions, carrier communications, and declinations within Zoho CRM. The role focuses on SLA-driven queue handling and documenting processes for automation readiness, while ensuring proper escalation when needed.

You will contribute to process documentation, standardization, and reporting, helping the team improve accuracy and efficiency in a dynamic shared-services environment.

Qualifications

2-3 years in a process-driven administrative or shared-services role with high-volume, detail-heavy work
Exposure to logistics or transportation industry
A documented instance of improving or standardizing a process, not only executing one
Experience in accounts receivable or a claims environment advantageous
BPO background and early member of a new function advantageous

Responsibilities

Log claim submissions in Zoho CRM accurately and within SLA
Verify required fields and documentation before submission
Return submissions blocked by missing information with clear notes
Maintain submission records to reconstruct each claim"s history
Monitor shared correspondence inbox and attribute to the correct record
Escalate unmatched, duplicate, or ambiguous correspondence
Capture carrier declinations against the correct claim record and code reasons
Maintain a daily queue log and report SLA performance weekly
Document processes as performed and ensure controlled documentation
Identify automation opportunities and support CRM improvements

Skills

Attention to detail

Written English

Escalation skills

Process documentation

Education

Diploma / College degree in Business Admin / Logistics

Tools

Zoho CRM

Salesforce

ServiceNow

Microsoft Office

Job description

Ready to run the queue and improve it too?

Hi! We're Smartsourcing, and we're hiring a full-time, onsite CRM Claims Process Administrator. You'll keep a shared claims queue accurate and on time, and leave every process in better shape than you found it.

Where? JEG Tower, Archbishop Reyes, Corner Acacia St., Barangay Kamputhaw, Cebu City, 6000 Cebu

About the Role

You'll work behind the scenes in Zoho CRM for a team of account relationship managers. You'll log claim submissions, match carrier acknowledgments, approvals, and declinations to the right claim record, and code declination reasons to a standard taxonomy. The role has two equally weighted halves: running the queue to SLA, and documenting and standardizing the processes so they can be automated. You record outcomes rather than own them, so the account relationship manager stays the sole owner of carrier and client relationships. Anything unmatched, ambiguous, contested, or high value gets escalated promptly. That is expected behavior here, not an exception.

Key Responsibilities

Claim Submission Administration

Log claim submissions in Zoho CRM accurately and within SLA.
Verify required fields and supporting documentation are complete before a submission is marked.
Return submissions blocked by missing or inconsistent information to the assigned relationship manager, stating what is missing.
Maintain submission records so each claim's filing history can be reconstructed from the record alone.

Carrier Correspondence Capture

Monitor the shared correspondence inbox through the shift.
Attribute acknowledgment, approval, and declination correspondence to the correct claim record and update the claim status.
Escalate unmatched, duplicate, or ambiguous correspondence rather than attributing it by inference.
Notify the account relationship manager when an approval is recorded.

Declination Administration

Capture carrier declinations against the correct claim record.
Code each declination reason using the standard reason taxonomy and route the record to the correct next step.
Escalate declinations with an unclear reason code, or that are contested, complex, or high value.

Queue Management & Reporting

Maintain a daily queue log covering volume received, volume completed, time spent by function, and aging.
Report SLA performance, error rate, and queue health weekly.
Work down the existing backlog, prioritizing straightforward records.
Raise sustained backlog or volume spikes early rather than absorbing them silently.

Process Documentation & Standardization

Document each process as performed, including exception cases, to a standard a new joiner could follow unaided.
Maintain documentation as a controlled document as processes change.
Identify variation in how different relationship managers handle the same task and propose a single standard method with rationale.

Automation Readiness & Process Improvement

Identify which process steps are rules-based and automatable versus those requiring human judgment.
Maintain a ranked register of automation candidates, based on hours consumed and error frequency.
Recommend improvements to CRM stages, fields, templates, and data capture that reduce manual handling.
Raise data-quality problems at source rather than correcting them repeatedly downstream.
Support and validate the automation build against the documented process.

Artificial Intelligence (AI) Readiness and Digital Enablement

Maintain baseline AI literacy and use approved AI tools responsibly, in line with company policies, data privacy, information security, and client confidentiality obligations.
Apply sound judgment by validating outputs and avoiding overreliance, ensuring accuracy and accountability in all work delivered.
Participate in AI readiness trainings and proactively identify opportunities for process improvement through automation and responsible AI integration.

Experience

2-3 years of experience in a process-driven administrative or shared-services role, with demonstrated accuracy on high-volume, detail-heavy work
Exposure to the logistics or transportation industry
A documented instance of improving or standardizing a process, not only executing one
Experience in accounts receivable or a claims environment advantageous
BPO background and experience as an early member of a newly established function advantageous

Skills & Behaviours

Clear written English, as escalations are made in writing to onshore colleagues
Sound judgment about when to elevate rather than improvise
Comfortable with daily volume that varies substantially
Experience authoring process documentation or SOPs preferred

Education & Certifications

Diploma, college-level qualification, or bachelor's degree in Business Administration, Logistics, Supply Chain, Accounting, or a related field preferred
Lean, Six Sigma, or equivalent continuous improvement training advantageous

Tools

Working competence in a CRM or case management system (Zoho, Salesforce, ServiceNow, or similar) and Microsoft tools, required
Zoho CRM experience preferred
Exposure to workflow automation, RPA, or rules configuration advantageous

Benefits

Step Into the Smartsourcing Experience

Smartsourcing was created with one mission: to change lives. We're here to ensure that businesses flourish and, just as importantly, that every member of the crew is inspired, supported, and set up to thrive. For the fifth year running, we've been recognized as one of HR Asia's Best Companies to Work For. This award isn't just a title--it's a testament to our commitment to making Smartsourcing an incredible place to build a career.

Why You'll Love Working Here

At Smartsourcing, we believe the best work comes from people who feel seen, heard, and valued. That's why we're all about fostering an environment where you can be your true self. We take pride in being certified as a Great Place to Work, because we know that when you love where you work, extraordinary things happen. Here's just a glimpse of what we offer: