INSURANCE ACCOUNT CLAIMS

Datamatics; Pasig; On-site; PHP 558,000 - 725,000; Full time

Job summary

Datamatics is seeking a Claims Support Specialist in the Philippines to assist the claims team with high-volume administrative tasks. You will process FNOL reports, respond to inquiries, perform data entry, and manage document workflows while delivering empathetic service to insureds and partners.

The role requires a high school diploma or GED and 2–4 years of customer service or back-office experience. Familiarity with CRM systems like Salesforce or Origami is a plus and the ability to handle

Qualifications

• High school diploma or GED equivalent.
• 2–4 years of customer service/back office experience is preferred.
• Experience in claims processing, insurance operations, or a BPO environment is desirable.
• Familiarity with Workers’ Compensation policies and regulatory requirements is a plus.
• Proficiency in Salesforce, Origami, or similar CRM/claims management systems is a plus.
• Strong attention to detail with ability to accurately transcribe and route information across systems.
• Ability to handle high call and task volume while maintaining quality and composure.
• Excellent verbal and written communication skills.

Responsibilities

• Process Workers Comp FNOL reports via phone, email, or web; complete claim questionnaires in Origami.
• Process FNOL intake for specific jurisdictions and enter claims in Origami with policy documentation.
• Provide FNOL overflow support during high-volume periods.
• Verify policy coverage by date of injury and provide documents to parties upon request.
• Handle inbound calls and emails with general questions; escalate to adjuster as needed.
• Provide claim status updates within defined scope; route complex questions to appropriate teams.
• Respond to payment status inquiries; coordinate with finance as needed.
• Review scanned mail in Filebound exception queue and route to claims via SFTP or triage.

Skills

Attention to detail

Communication skills

Customer service

BPO/claims processing

CRM (Salesforce Origami)

Education

High school diploma or GED

Tools

Salesforce

Origami

Job description

About the role

The Claims Support Specialist holds a central position in the claims support function. This role handles high-volume, semi-routine administrative tasks across both voice and written channels, enabling claims adjusters and internal teams to focus on complex case management. Working within clearly defined procedures, you will process and establish first notice of loss (FNOL) reports, respond to general claim inquiries, perform data entry, and manage document workflows — all while delivering accurate, timely, and empathetic service to insureds, claimants, and partners.

Key responsibilities

• Process Workers Comp first notice of loss reports submitted via phone, email, or web; complete claim questionnaires in Origami
• Process FNOL intake for CorVel jurisdictions (AK/NM/NV/OR) or Sirius Point policy term; enter claim in Origami and provide abstract with policy documentation
• Provide FNOL overflow support during high call volume periods when queue exceeds capacity
• Verify policy coverage based on date of injury via email template; provide policy information and documentation to requesting parties
• Handle inbound calls and emails from insureds and involved parties with general questions about whether an incident could or should be reported; elevate to adjuster as needed
• Provide claim status updates within defined scope; route complex questions to customer care advocates or adjusters as appropriate
• Respond to payment status inquiries including check status, direct deposit status, and payment confirmation; coordinate with finance team as needed
• Review scanned physical mail from PO Box in Filebound exception queue; send to claim via SFTP or triage appropriately
• Maintain a consistent standard of accuracy across all data entry, document routing, and customer interactions
• Ensure all tasks are completed within specified Service Level Agreements, meeting organizational standards for efficiency and timeliness

About you

• High school diploma or GED equivalent required
• Two to four years of customer service, administrative, or back office experience preferred
• Previous experience in claims processing, insurance operations, or a BPO environment is highly desirable
• Familiarity with Workers Compensation policies and regulatory requirements is a plus
• Proficiency in Salesforce, Origami, or similar CRM/claims management systems is a plus
• Strong attention to detail with the ability to accurately transcribe and route information across systems
• Ability to handle high call and task volume simultaneously while maintaining quality and composure
• Excellent verbal and written communication skills with a professional, empathetic customer service approach