Remote Claims Specialist — Fast, Empathetic Insurance Support

MicroSourcing; Manila; On-site; PHP 335,000 - 469,000; Full time

Benefits offered by this job

Healthcare coverage on day one

Paid time-off with cash conversion

Performance bonuses

Group life insurance

Flexible work arrangements

Job summary

MicroSourcing is seeking a Customer Specialist to own the customer experience for insurance products. You will manage tickets, organize inboxes in the XClaim platform, and ensure timely resolutions and payments while collaborating with Support and Claims teams to meet SLAs and NPS targets.

Ideal candidates have strong attention to detail, organizational and time management skills, and experience handling online customer queries. This remote role offers day shift across the Philippines.

Qualifications

• 1–2 years experience handling customer queries online, ideally in a call-centre environment.
• Fluency in English (verbal and written).
• Ability to handle customer inquiries across multiple channels.
• Excellent verbal and written communication skills.
• Proven ability to identify problems and raise them for a solution.

Responsibilities

• Manage the end-to-end claims process, from initial assessment through approval, resolution, and payment.
• Assess claims against policy terms, insurance guidelines, and regulatory requirements to ensure fair and accurate decisions.
• Maintain complete and accurate claim records, documentation, and supporting evidence.
• Communicate with customers clearly and empathetically, providing timely updates and resolving queries throughout the claims process.
• Identify potential fraud or irregularities and elevate suspicious claims for further investigation.
• Collaborate with the Team Lead to resolve complex claims and ensure appropriate outcomes.
• Meet key KPIs, including turnaround time, accuracy, productivity, and customer satisfaction, while maintaining required performance standards.
• Identify and recommend process improvements to increase efficiency, reduce errors, and enhance the customer experience, and communicate recommendations to the Team Lead.
• Support team development by collaborating with fellow assessors, sharing knowledge, and promoting best practices.

Skills

Customer support

English fluency

Multichannel support

Time management

Attention to detail

Tools

Zendesk

XClaim

Job description

Key Responsibilities

Discover your 100% YOU with MicroSourcing!

Position: Customer Specialist

Work setup & shift: Work From Home | Day shift

Why join MicroSourcing?

You'll Have

• Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
• A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
• Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
• Career Growth: Take advantage of opportunities for continuous learning and career advancement.
• Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.
  
  

About The Role

As a Customer Specialist on our Customer Team, you will own the excellence of customer experience, ensuring tickets and claims are handled in a timely manner, and inboxes are organized to deliver a great service to customers using our insurance products.

To drive success in this role, you will have strong attention to detail and great organizational and time management skills. You will ideally have experience dealing with customers' queries and litigations online. As the Customer Specialist, you will organize the customer inbox, review and assess customers' claims through our owned XClaim platform, for a fast resolution and prompt payment, ensuring customers' inquiries are resolved in a timely manner. Regular collaboration with the Support and Claims team, will be key in ensuring that agreed SLAs and NPS are achieved.

Key Responsibilities

Claims tasks

• Manage the end-to-end claims process, from initial assessment through approval, resolution, and payment.
• Assess claims against policy terms, insurance guidelines, and regulatory requirements to ensure fair and accurate decisions.
• Maintain complete and accurate claim records, documentation, and supporting evidence.
• Communicate with customers clearly and empathetically, providing timely updates and resolving queries throughout the claims process.
• Identify potential fraud or irregularities and escalate suspicious claims for further investigation.
• Collaborate with the Team Lead to resolve complex claims and ensure appropriate outcomes.
• Meet key KPIs, including turnaround time, accuracy, productivity, and customer satisfaction, while maintaining required performance standards.
• Identify and recommend process improvements to increase efficiency, reduce errors, and enhance the customer experience, and communicate recommendations to the Team Lead.
• Support team development by collaborating with fellow assessors, sharing knowledge, and promoting best practices.
  
  

Support tasks

• Own the resolution of customers' and partners' inquiries throughout multiple channels.
• Create an ongoing collaboration with the Team Lead to identify improvements to existing customer service processes
• Lead the implementation of new processes to achieve individual and team's KPI's
• Own the quality of our work, including presentation, accuracy, and detail of each particular case, by meeting and exceeding the business KPIs
  
  

Claims Admin

• Own the triage of tickets into the corresponding inboxes in the different systems (Zendesk, XClaim, other)
• Redirect claims/complaints/support tickets to the dedicated inboxes and team for resolution
• Lead the categorization of the ticket with specific information when required
• Organize the upload of documents and any customer information into the different systems
• Manage translation of tickets via Google translator
• Own admin tasks on partner sites as per the needs (ie. invoice upload)
  
  

Skills And Experience

What you will bring

• 1–2 years' experience handling customer queries online, ideally in a call-centre environment.
• Fluency in English (verbal and written).
• Ability to handle customer inquiries across multiple channels.
• Excellent verbal and written communication skills.
• Proven ability to identify problems and raise them for a solution.
• Experience or interest in claims, insurance, administration, or customer service.
• Strong attention to detail and accuracy when reviewing information, documents, and claims.
• Ability to follow policies, procedures, and guidelines when handling claims and customer requests.
• Strong organisation and time management skills, with the ability to manage multiple tasks and meet deadlines.
• Ability to work collaboratively with Team Leads and colleagues while maintaining a high standard of customer service.
  
  

PROFICIENCIES AND ATTRIBUTES

What You Will Have

• Strong problem-solving and decision-making skills with a practical approach.
• Customer-focused, professional, and empathetic when handling enquiries and claims.
• Ability to work independently and collaboratively with Team Leads and colleagues.
• Flexible and adaptable to changing priorities and business requirements.
• Strong commitment to quality, compliance, confidentiality, and accuracy.
• Ability to work under pressure while maintaining service and performance standards.
• Willingness to learn, share knowledge, and support team members.
  
  

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About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan – it's our commitment. Our way of life. Here, we don't just accept your unique authentic self - we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit https://www.microsourcing.com/

• Terms & conditions apply