Application Form

Claims Manager


  • Adjudicates claim
  • Initiates or conducts investigations of questionable claims
  • Resolves claims by approving or denying, calculating benefits due, initiating payment, preparing notice to member after case adjudication by indicating remarks in the system
  • Documentations of the medical claims by preparing worksheets for inpatient cases, data entry in the system, reports, logs, and records
  • Maintains quality services by following client service practices and responding to customer inquiries
  • Performs second-layer checking of claims proposed by junior assessors
  • Handles specific portfolios with specific service agreement


  • Bachelor’s degree in a medical-related field is an advantage
  • At least 4 years of relevant experience in the Healthcare, Insurance, or BPO industry
  • Excellent verbal and written communication skills
  • Proficient in Windows OS, MS Office applications
  • Has a Knowledge of medical and insurance terminologies
  • Has critical thinking skills with a focus on issue resolution and customer satisfaction
  • Can multitask and has a high attention to details