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Claim and Processing Associate

Full-time

Topserve Service Solutions, Inc.

  • Reviewing client's insurance coverage and interviewing those who have filed a claim. 
  • Analyzing and investigating complicated insurance claims to help prevent fraud. 
  • Performing detailed site inspections.
  • Reviewing and processing new claims reports.
  • Upholding relationships and communication with insurance departments and clients. 
  • Organizing and presenting claim review plans. 
  • Assisting customers in determining need and eligibility of services available, calculating and assigning appropriate reserves to claims, and managing reserve adequacy throughout the life of the claim. 
  • Determining benefits due pursuant to the client contract. 
  • Handling claims files. 
  • Investigating claims by determining applicable policy coverage, evaluating damages, and settling assigned claims.
    • Experience as a claims processor or similar role in insurance is a plus
    • Familiarity with insurance policies and claims procedures
    • Good data entry and data processing skills
    • Attention to detail and analytical skills
    • Ability to handle confidential and sensitive information
    • Good communication and negotiation skills
    • Bachelor’s degree in any course is a must
    • Wiling to work on-site in Ortigas, Pasig

Vacancy posted 25 days ago
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