Medical Claims Specialist

Bolttech Inc; Philippines; On-site; PHP 240,000 - 420,000; Full time

Job summary

Bolttech Inc. is seeking a Service Officer in the Philippines to manage medical claims, verify insurance coverage, and ensure accurate documentation. You will resolve complex claims, maintain high-quality customer service, and support compliance through diligent record-keeping.

The role requires strong communication, analytical skills, and the ability to work cross-functionally with insurers and internal teams to reach timely, fair outcomes.

Qualifications

• Minimum 2 years experience in handling medical claims.
• Ability to identify fraud claims.
• Good written and verbal communication, probing and listening skills.
• Collaborative and cooperative with other stakeholders to achieve solutions.
• Strong analytical skills, attention to detail and creative problem solver.
• Computer literacy in Word, Excel and PowerPoint.

Responsibilities

• Studying provisions of policy or certificate.
• Initiating or conducting investigation of questionable claims.
• Completing forms, reports, logs, and records in relation to claims or services.
• Maintaining quality customer services by following customer service practices; responding to customer inquiries and providing timely updates to the customer.
• Preparing reports by collecting, analyzing, and summarizing information.
• Determines covered medical insurance losses by studying provisions of policy or certificate.
• Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant or other sources, initiating or conducting investigation of questionable claims.

Skills

Communication

Collaboration

Customer Focus

Adaptability

Creativity

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Job description

Bolttech Inc. is seeking a Service Officer in the Philippines to manage medical claims, verify insurance coverage, and ensure accurate documentation. You will resolve complex claims, maintain high-quality customer service, and support compliance through diligent record-keeping.

The role requires strong communication, analytical skills, and the ability to work cross-functionally with insurers and internal teams to reach timely, fair outcomes.