Claims Analyst - MoneeInsure

1-3 Years

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Early Applicant

Job Description

Job Description

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.

System Enhancement and Coordination

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.

Operational Optimization

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.

Requirements

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