Claims Analyst - SeaInsure
Monee
Date: 2 weeks ago
City: Manila
Contract type: Full time
Job Description
Claims Evaluation and Processing
Claims Evaluation and Processing
- Utilize our CRM system as the primary system for claims management and processing.
- Review and assess claims documentation for accuracy and completeness.
- Analyze coverage and liability based on policy terms and conditions.
- Determine the legitimacy of claims and identify potential fraudulent activities.
- Calculate claim payouts and ensure timely and accurate processing of claims.
- Coordinate with the Product Management Team to suggest Bytesforce system enhancements for claims processes
- Support quality assurance and user acceptance testing (UAT) efforts, working with relevant stakeholders to align with system and customer requirements.
- Work alongside business and cross-functional teams to constantly optimize operational processes and improve the product experience for both internal and external users.
- Identify and suggest opportunities for process improvements and increased efficiency.
- A Bachelor’s Degree in Finance, Commerce or any medical field
- Minimum of 1 year of experience in a Life / general Insurance firm.
- Good understanding of the local life and health insurance product market.
- Understanding of health-related claims and overall Filipino health service systems (i.e. public / private healthcare, clinics, other providers) network
- Good understanding of local regulatory requirements, particularly from a claims perspective
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