Claims Analyst
Sun Life Financial
Taguig, Manila
4d ago

Job Description :

Appraises and approves claims within prescribed approval limits, performs initial review of claims beyond authorized approval limits and submits recommended course of action to Claims Manager.

Specific Accountabilities :

  • Appraises and approves death and living benefit claims within approval limits. Secures Underwriting, Legal and / or Medical input where necessary.
  • Appraises claims beyond authorized approval limits, prepares written analysis and recommended course of action and submits to Claims Manager for review and approval.
  • Reviews and approves check request within CAS approval limits and initially reviews and submits to Claims Manager for approval those beyond CAS approval limits.
  • Attends to claim inquiries ranging from basic to complex in nature.
  • Represents Sun Life in mediation required by Insurance Commission and Court hearing, as required, involving cases appraised within approval limits.
  • Conducts learning sessions for Claims Services Section, as required.
  • Skills and Knowledge Required :

  • Graduate of any four-year course. A medical / allied medical science or legal background would be an advantage.
  • Computer literate.
  • Very good analytical, judgment, comprehension and conceptual thinking skills
  • Detailed-oriented, organized, systematic.
  • Patient and interested to read and familiarize self with provisions of the law, medical materials and review and scrutinize various documents.
  • Can work independently and is decisive.
  • Can work ably under pressure and multi-task.
  • With strong customer service orientation and good sense of urgency.
  • Possesses effective interpersonal relationship skills and is a team player.
  • With above average written and verbal English communication skills.
  • Willing to study and pursue required LOMA and ICA courses under Claims Career Development Program.
  • With good attendance and punctuality record.
  • Job Category :

    Claims - Life & Disability

    Posting End Date : 26 / 09 / 2019

    26 / 09 / 2019

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