Claims Assistant (Insurance)

WHR Global Consulting, a global talent solution provider is looking for a stellar candidate to fill the role of Claims Assistant / Claims Clerk for its client based in Alabang, Muntinlupa.

Salary Rate: 25k
Work Setup: Onsite
Work Schedule: Mon-Fri | Day-shift

Qualifications:
- Graduate of any 4 yrs bachelor’s degree.
- 2 – 4 yrs experience in Non-Motor Claims or having prior experience in a claims department or working with insurance claims can be a significant advantage.
- Prior administrative or customer service experience, preferably in an insurance, healthcare, or financial services environment.
- Proficient in Microsoft Office Suite (Excel, Word, etc.) and familiarity with claims management software.

Duties:
- The Claims Assistant provides administrative support in the claims process by helping with the preparation, documentation, and communication involved in handling claims. This role ensures smooth and efficient processing of claims, assisting both claimants and internal teams in various tasks related to claims management.

- Claims Data Entry: Input claim data into the system, ensuring all information is accurate, up-to- date, and properly filed.
- Claims Documentation: Assist in collecting and organizing all necessary documentation for claims, including medical reports, receipts, and forms.
- Claims Review: Analyze claims data to identify discrepancies, fraud, or errors and escalate complex claims to senior claims staff or managers
- Investigation: Conduct initial investigations when necessary to gather additional information or verify claims details.
- Claims Settlement: Assist in the negotiation or determination of appropriate settlements within established guidelines.
- Claims Follow-up: Follow up with clients, healthcare providers, or third parties to ensure all necessary documentation is received for timely claim resolution.
- Correspondence: Communicate with clients, vendors, adjusters, and internal departments to request additional information or clarify details.
- Customer Support: Answer inquiries from claimants or policyholders about claim status, required documentation, and timelines, and provide status updates as necessary.
- Claims Filing: Maintain accurate and organized physical or electronic files for each claim.
- Compliance: Ensure compliance with industry regulations, company policies, and procedures in handling claims.
- Administrative Support: Provide general administrative support, such as scheduling meetings, preparing claim-related reports, and assisting with other clerical tasks.
- Reporting: Assist in preparing reports and updates regarding claims processing performance or claim trends for management.