Medical Coding (Non-Voice / AUS Shift)

QBE Insurance; Cebu City; On-site; PHP 240,000 - 420,000; Full time

Job summary

QBE Insurance is seeking a claims professional to deliver service by accurately assessing policy coverage, investigating, evaluating, and negotiating assigned cases to resolution.

The role requires experience in motor claims, familiarity with insurance guidelines, and the ability to communicate clearly with stakeholders while maintaining confidentiality. This position emphasizes compliance with policies and timely client communication.

Qualifications

• Some relevant work experience in motor claims.
• Some experience in insurance.
• Tertiary degree or equivalent combination of education and work experience.

Responsibilities

• Maintain current knowledge of insurance guidelines and policy changes.
• Resolve non-compliant issues and escape when necessary.
• Maintain good client relationships and respond to client requests promptly.
• Process incoming insurance claims and determine coverage.
• Set reserves, authorise payments, and settle claims efficiently.
• Identify and report suspicious or fraudulent claims.
• Share information with stakeholders while considering confidentiality guidelines.
• Ensure compliance with accreditation levels and policies.
• Provide clear and timely communication with all stakeholders.

Skills

Analytical Thinking

Claims Administration

Claims Processing

Claims Resolution

Communication

Critical Thinking

Customer Service

Customer Value Management

Financial Advising

Intentional collaboration

Managing performance

Process Compliance

Process Improvements

Risk Management

Stakeholder Management

Education

Tertiary Degree or equivalent combination of education and work experience

Job description

Primary Details

Time Type: Full timeWorker Type: EmployeeThe purpose of this role is to deliver claims service by accurately assessing policy coverage, investigating, evaluating, and negotiating assigned cases to resolution.

Responsibilities

• Maintain current knowledge of insurance guidelines and policy changes.
• Resolve non-compliant issues and escape when necessary.
• Maintain good client relationships and respond to client requests promptly.
• Process incoming insurance claims and determine coverage.
• Set reserves, authorise payments, and settle claims efficiently.
• Identify and report suspicious or fraudulent claims.
• Share information with stakeholders while considering confidentiality guidelines.
• Ensure compliance with accreditation levels and policies.
• Provide clear and timely communication with all stakeholders.

Necessary Work Experience

• Some relevant work experience in motor claims.

Preferred Work Experience

• Some experience in insurance

Preferred Qualifications

• Tertiary Degree or equivalent combination of education and work experience.

Global Disclaimer

The duties listed in this job description do not limit the assignment of work. They are not to be construed as a complete list of the duties normally to be performed in the position or those occasionally assigned outside an employee’s normal duties. Our Group Code of Ethics and Conduct addresses the responsibilities we all have at QBE to our company, to each other and to our customers, suppliers, communities and governments. It provides clear guidance to help us to make good judgement calls.

US Only Disclaimer

To successfully perform this job, the individual must be able to perform each essential job responsibility satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities.

US Only – Travel Frequency

Occasional (approximately 5-10 trips annually)

US Only – Physical Demands

General office jobs:

• Work is generally performed in an office environment in which there is not substantial exposure to adverse environmental conditions.
• Must have the ability to remain in a stationary position for extended periods of time.
• Must be able to operate basic office equipment including telephone, headset and computer.
• Incumbent must be able to lift basic office equipment up to 20 lbs.

Skills

Analytical Thinking, Claims Administration, Claims Processing, Claims Resolution, Communication, Critical Thinking, Customer Service, Customer Value Management, Financial Advising, Intentional collaboration, Managing performance, Process Compliance, Process Improvements, Risk Management, Stakeholder Management

Equal Employment Opportunity

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.