Claims Examiner jobs

JOB SUMMARY Responsible for the accurate and timely review of complex claims in accordance with applicable contracts, state and federal regulations, health plan requirements, policies and procedures, and generally accepted business practices. ESSENTIAL DUTIES AND RESPONSIBILITIES - Analyzes professional and hospital claims for accuracy according to set dollar thresholds and meets and maintains...

Overview Role Purpose: The primary purpose of the Claims Examiner is to produce a high quality Claims work through prompt and professional contact with customers and brokers. Manage and assess high frequency, simple/ low value claims through effective investigation, reserving and adjustment of claims incurred by insureds across Asia Pacific countries supported. Responsibilities - Process...

Role Purpose The primary purpose of this role is to produce a high-quality Claims work through prompt and professional contact with customers and brokers. Manage and assess high frequency, simple/ low value claims through effective investigation, reserving and adjustment of claims incurred by insureds across Asia Pacific countries supported. Key Responsibilities - Process claims document and...

The primary purpose of Claims Examiner is to produce a high quality Claims work through prompt and professional contact with customers and brokers. Manage and assess high frequency, simple/ low value claims through effective investigation, reserving and adjustment of claims incurred by insureds across Asia Pacific countries supported. Key Responsibilities - Process claims document and index to...

Qualifications - Graduate of a Bachelor’s Degree of any allied medical profession. - License is required—RN, PTRP, RPH, or OD. - Minimum of one year Philippine or US healthcare insurance and claims experience is required. - Ability to work full‑time schedule including extended hours, weekends, and holidays. - Knowledge of healthcare insurance and medical terminology; codes—ICD‑9, CPT, HCPCS;...

Exciting, life-changing Claims opportunities with Chubb Business Services Philippines. Join our Claims team (or refer a friend). We have multiple open vacancies in our Claims Tower such as Claims Admin, Claims Examiners, Claims Team Leads, Claims SME and many others...! Our Claims team ensures that we are delivering exceptional, world-class Claims services to our globally distributed...

Exciting life-changing) Claims opportunities with Chubb Business Services Philippines. Join our Claims team (or Refer a friend). We have multiple open vacancies in our Claims Tower such as Claims Admin, Claims Examiners, Claims Team Leads, Claims SME and many others...! Our Claims team ensures that we are delivering exceptional, world-class Claims services to our globally distributed...

This role is responsible for the end-to-end administration, validation, and reconciliation of Third-Party Administrator (TPA) claims within Chubb’s claims systems. Acting as a key liaison between TPAs, claimants, brokers, and internal teams, the coordinator ensures the accuracy and integrity of claims data, manages complex claim transactions, and facilitates timely settlements. The role requires...

Role We are pooling qualified applicants in preparation for anticipated openings in the second and third quarters. We are in the business of paying claims- your role is to help us uphold this promise. The Claims Adjudicator is responsible for evaluating and processing claims from policy holders, hospitals, laboratories, and clinics. This role ensures that our clients and accredited facility...

Medical Claims Manager Join to apply for the Medical Claims Manager role at Conifer Health Solutions. Provides direction to the Claims Unit team while monitoring daily workflows, examiner assignments and production, and ensuring compliance with health plan and regulatory requirements. Job Duties and Essential Functions - Responsible for compliance of all claims regardless of department where...

The Claims Evaluator/Examiner is responsible for investigating, evaluating, and processing non-life insurance in accordance with company policies, procedures, and regulatory requirements. The role ensures timely, fair, and accurate settlement of claims while maintaining excellent customer service and minimizing company losses. Roles and Responsibilities - Receive, review, and acknowledge...

On-site - Makati 1-3 Yrs Exp Bachelor Full-time Job Description - Receive and review claims documents and coordinate with claimants - Interview claimant(s) and/or witnesses to gather pertinent information - Conduct an actual investigation or inspection to determine the veracity of the loss and the extent of the insurance company's liability concerning personal, casualty, or property loss or...

Claims Officer BENEFITS/PERKS - Competitive Salary - 13th and 14th month guaranteed - Performance Incentive Plan / Yearly Bonus - Retirement Program and Group Life Insurance - Hybrid Work Set-up after 6 months of employment - Be part of a pioneer team JOB DETAILS / ROLE PURPOSE The role of Claims Officer involves processing medical claims for clients in their assigned region. We ensure a high...

A leading firm in medical examinations is seeking an individual to manage IMO support and review medical records for veterans. This role demands excellent English communication skills and attention to detail, with responsibilities including managing a high volume of medical exams and documenting research performance. A background in healthcare is essential. The position is based in Manila and...

Account Executive/Broker II - (Professional Liability) New York (hybrid) Provide detailed support to Senior Vice-President on complex Professional Liability, Employment Practices Liability, Management Liability, and Cyber insurance placements; ensure all clients’ needs are promptly and accurately satisfied; ensure all deadlines are met on a timely basis; ensure quality standards are maintained...

A global insurance provider in Metro Manila seeks a Claims Examiner to efficiently manage and assess high frequency, low value claims. Responsibilities include processing claims documents, setting loss reserves, and ensuring quality in claims administration. Applicants should possess strong analytical skills, attention to detail, and ideally have a Claims Insurance background. This position...

A global insurance firm in the Philippines is seeking a Claims Examiner to manage and assess claims effectively while ensuring quality customer service. Responsibilities include processing claims documents, maintaining databases, and liaising with customers and brokers. The ideal candidate should have strong analytical skills and the ability to handle multiple claims efficiently. This role...

A leading insurance company in Mandaluyong is seeking a Claims Processor to manage various insurance claims. The ideal candidate will have analytical skills, strong communication, and customer service abilities, along with a background in claims insurance preferred. This role involves processing claims documents, maintaining positive relationships with customers and brokers, and ensuring quality...

Role Purpose: The primary purpose of this role is to produce a high quality Claims work through prompt and professional contact with customers and brokers.Manage and assess high frequency, simple/ low value claims through effective investigation, reserving and adjustment of claims incurred by insureds across Asia Pacific countries supported. Key Responsibilities: 1. Process claims document and...

A healthcare management company in Pasig is seeking a Claims Examiner responsible for reviewing complex claims accurately and timely per regulations and policies. Key duties include analyzing claims for accuracy, reviewing contracts, and assisting customer service with issues. Candidates should have a solid understanding of health managed care and coding schemes like ICD.9.CM and CPT, with 2-5...