97 Claims Processing jobs in the Philippines

Join Our Growing Team at Cliniqon

Make a real impact in a company that values your expertise and rewards your dedication.

If you're passionate about the details, know your way around dental billing like a pro, and want to grow with a company that truly values your work—you could be exactly who we're looking for.

Responsibilities:

• Accurately review and submit dental insurance claims using correct CDT codes and required documentation
• Post insurance and patient payments—including EOBs, EFTs, and paper checks
• Investigate and resolve claim issues such as denials, underpayments, and coordination of benefits
• Follow up with insurance providers on unpaid or rejected claims
• Keep clean, up-to-date records of claim statuses, payment activity, and adjustments
• Work closely with front office, billing, and clinical teams to ensure accurate coding and documentation
• Generate reports on claims aging, payment trends, and outstanding balances

Requirements:

• Strong knowledge of dental billing procedures, CDT coding, and insurance guidelines
• Experience with dental practice management software (Dentrix preferred )
• Incredible attention to detail and organizational skills
• Excellent communication and problem-solving abilities
• Familiarity with HIPAA and dental compliance standards
• Ready to start on ASAP

Benefits:

• Permanent Work-from-Home
• Retention & Performance Bonuses
• HMO Coverage
• Company-Provided Equipment
• Career Growth Opportunities
• Supportive and collaborative team culture

Apply Now

Send your resume to and take the next exciting step in your dental career.

At Cliniqon, your skills matter. Your work matters. You matter.

We can't wait to meet you

Job Type: Full-time

Benefits:

• Flexible schedule
• Health insurance
• Life insurance
• Opportunities for promotion
• Paid training
• Pay raise
• Work from home

Application Question(s):

• Have you worked with dental practice management software such as Dentrix?
• Do you have experience posting payments from EOBs, EFTs, and checks?
• Are you comfortable resolving claim denials and underpayments?
• Are you amenable to start on ASAP?

Work Location: Remote

Review and evaluate data on claim forms and supporting documents.

Process for payment on- and off-island medical, dental, and pharmacy claims.

Review and verify authorized charges on claim statements.

Prepare correspondence to providers regarding billing issues and benefit coverage.

Handle data entry of medical, dental and pharmacy claims into the computer for processing.

Re-evaluate evidence and obtain additional information in connection with claims pended, denied or under appeal.

Ensure that all claims and payments are reconciled.

Coordinate daily activities, including handling of complaints, with various departments such as enrollment and customer care.

Ensure participation to various company programs, activities and committees, such as but not limited to training and development programs, collegial planning, collaborative ad-hoc projects, and other company-sponsored events, as necessary.

Adhere to all set Organization policies, procedures and standards, and promote culture of compliance and continuous improvement among the existing manpower pool.

Adhere to all policies, procedures and standards set by the company, and help promote the culture of compliance and continuous improvement within the Organization.

Perform job functions consistent with the company's vision and mission statements, and core values.

Perform other duties, roles and responsibilities analogous, related, similar, germane and/or implied to the above-mentioned.

Requirements:

• Doctor of Dental Medicine, or Bachelor's Degree in Nursing, Pharmacy or any allied medical fields
• Computer literate, preferably with working knowledge in using MS Office Suite (Word, Excel, PPT, etc.)
• Knowledge on basic medical terminology and claims procedures
• Ability to solve basic claim issues and concerns
• Basic business communication skills
• Knowledge of basic accounting principles

Duties and Responsibilities

• Receives and examines claims applications: Death, Disability, Killed-In-Action, Wounded-In-Action, Accident Hospitalization Benefits and other benefits of deceased members
• Determines coverage and corresponding benefit of claims and computes individual shares of beneficiaries
• Initiates suggestion and recommendation on claims with any legal issues to be resolved
• Transmits disability and WIA claims to medical consultant for evaluation
• Prepares claims disbursement vouchers and communication letters to claimants indicating claims settlement, computation benefit and completion of documents
• Encodes claims transactions in database and scans documents for reference
• Aids in communicating with beneficiaries regarding denied claims and claims with legal issues
• Prepares report on claims with CLI and E56 insurance coverage
• Handles claim register and prepares monthly claims register report
• Answers queries regarding claims from walk-in members
• Performs other related functions as directed by superior

Key Organizational Relationships

• Reports directly to the Supervisor, Claims

Qualifications

• Bachelor's degree in any business course
• With a minimum of 1-year related experience and relevant technical trainings, preferably on signature verification and forgery detection etc.
• Proficient in MS Office applications
• Strong analytical, composition, and prioritizing skills
• Detail-oriented and with good organization and coordination skills
• Ability to maintain confidentiality
• Good written and oral communication skills

ey Responsibilities:

1. Process claims document and index to appropriate claims files in the system.

2. Responsible for FNOL (First Notice of Loss)/ new claim files creation and registration in the system including policy verification/ upload of policy documents and determination of appropriate coverage.

3. Ensures loss reserves are set and maintained with timely updates of claims data into our systems, ensuring correctness of systems and file records

4. Review claim files and manage proper triage allocation:

5. To appropriate Claims Work Queue by claims type and coverage

6. To appropriate Claims Team by complexity (simple/ complex)

7. To appropriate Claims Department (Complaints, Recovery, Fraud)

8. Manage and assess claims (Fast Track, Within HFC Threshold, and Simple) from end to end including settlement in the system, responding to customer queries, providing updates, and requesting additional information as needed.

9. Prepares and sends written correspondences (e.g. Acknowledgment, Settlement etc.) to brokers, claimants and others as required.

10. Attend to claims enquiries and feedback, maintain positive relationship with all customers, brokers, providers etc.

11. Handles incoming and outbound queries from Customers and/ or Brokers.

12. Proactively apply claims policies and procedures including Chubb's policy in relation to fraud, salvage, recovery, cost containment and complaints.

13. Attends administrative activities (team huddles, trainings)

14. Performs other related duties as may be assigned by the supervisor/s

15. Immediately report potentially and confirmed Fraudulent cases, Compliance and Privacy Breaches to Management chain.

16. Nominate two process improvement ideas annually for SME and TL endorsement to the Manager.

Experience:

• Good analytical skills and strong attention to detail.
• Demonstrated strong communication skills (written and verbal) and interpersonal skills to be capable of dealing with all levels of Chubb personnel as well as claimants and brokers.
• Ability to organize work effectively and methodically and as a team and adjust to change driven by business needs.
• Ability to maintain a high level of quality in all claims administration activities ensuring the settlement times and complaint levels are minimized.
• Sound knowledge of claims administration procedures and related systems.

• Possess strong customer service behaviour.

• Tertiary Qualified or minimum 2-3 years similar work experience

• Claims Insurance background (is preferred)

ey Responsibilities:

1. Process claims document and index to appropriate claims files in the system.

2. Responsible for FNOL (First Notice of Loss)/ new claim files creation and registration in the system including policy verification/ upload of policy documents and determination of appropriate coverage.

3. Ensures loss reserves are set and maintained with timely updates of claims data into our systems, ensuring correctness of systems and file records

4. Review claim files and manage proper triage allocation:

5. To appropriate Claims Work Queue by claims type and coverage

6. To appropriate Claims Team by complexity (simple/ complex)

7. To appropriate Claims Department (Complaints, Recovery, Fraud)

8. Manage and assess claims (Fast Track, Within HFC Threshold, and Simple) from end to end including settlement in the system, responding to customer queries, providing updates, and requesting additional information as needed.

9. Prepares and sends written correspondences (e.g. Acknowledgment, Settlement etc.) to brokers, claimants and others as required.

10. Attend to claims enquiries and feedback, maintain positive relationship with all customers, brokers, providers etc.

11. Handles incoming and outbound queries from Customers and/ or Brokers.

12. Proactively apply claims policies and procedures including Chubb's policy in relation to fraud, salvage, recovery, cost containment and complaints.

13. Attends administrative activities (team huddles, trainings)

14. Performs other related duties as may be assigned by the supervisor/s

15. Immediately report potentially and confirmed Fraudulent cases, Compliance and Privacy Breaches to Management chain.

16. Nominate two process improvement ideas annually for SME and TL endorsement to the Manager.

Experience:

• Good analytical skills and strong attention to detail.
• Demonstrated strong communication skills (written and verbal) and interpersonal skills to be capable of dealing with all levels of Chubb personnel as well as claimants and brokers.
• Ability to organize work effectively and methodically and as a team and adjust to change driven by business needs.
• Ability to maintain a high level of quality in all claims administration activities ensuring the settlement times and complaint levels are minimized.
• Sound knowledge of claims administration procedures and related systems.
• Possess strong customer service behaviour.

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 index to appropriate claims files in the system.

2. Responsible for FNOL (First Notice of Loss)/ new claim files creation and registration in the system including policy verification/ upload of policy documents and determination of appropriate coverage.

3. Ensures loss reserves are set and maintained with timely updates of claims data into our systems, ensuring correctness of systems and file records

4. Review claim files and manage proper triage allocation:

To appropriate Claims Work Queue by claims type and coverage

To appropriate Claims Team by complexity (simple/ complex)

To appropriate Claims Department (Complaints, Recovery, Fraud)

1. Manage and assess claims (Fast Track, Within HFC Threshold, and Simple) from end to end including settlement in the system, responding to customer queries, providing updates, and requesting additional information as needed.

2. Prepares and sends written correspondences (e.g. Acknowledgment, Settlement etc.) to brokers, claimants and others as required.

3. Attend to claims enquiries and feedback, maintain positive relationship with all customers, brokers, providers etc.

4. Handles incoming and outbound queries from Customers and/ or Brokers.

5. Proactively apply claims policies and procedures including Chubb's policy in relation to fraud, salvage, recovery, cost containment and complaints.

6. Attends administrative activities (team huddles, trainings)

11.Performs other related duties as may be assigned by the supervisor/s

1. Immediately report potentially and confirmed Fraudulent cases, Compliance and Privacy Breaches to Management chain.

2. Nominate two process improvement ideas annually for SME and TL endorsement to the Manager.

Experience:

• Good analytical skills and strong attention to detail.
• Demonstrated strong communication skills (written and verbal) and interpersonal skills to be capable of dealing with all levels of Chubb personnel as well as claimants and brokers.
• Ability to organize work effectively and methodically and as a team and adjust to change driven by business needs.
• Ability to maintain a high level of quality in all claims administration activities ensuring the settlement times and complaint levels are minimized.
• Sound knowledge of claims administration procedures and related systems.
  Possess strong customer service behaviour.

Qualifications:

• Tertiary Qualified or minimum 2-3 years similar work experience
  Claims Insurance background (is preferred)

Languages:

English = 3/5 and Filipino = 3/5

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 index to appropriate claims files in the system. 
2. Responsible for FNOL (First Notice of Loss)/ new claim files creation and registration in the system including policy verification/ upload of policy documents and determination of appropriate coverage.
3. Ensures loss reserves are set and maintained with timely updates of claims data into our systems, ensuring correctness of systems and file records
4. Review claim files and manage proper triage allocation:
   
   • To appropriate Claims Work Queue by claims type and coverage
   
   • To appropriate Claims Team by complexity (simple/ complex)
   
   • To appropriate Claims Department (Complaints, Recovery, Fraud)
5. Manage and assess claims (Fast Track, Within HFC Threshold, and Simple) from end to end including settlement in the system, responding to customer queries, providing updates, and requesting additional information as needed.

6. Prepares and sends written correspondences (e.g. Acknowledgment, Settlement etc.) to brokers, claimants and others as required.

7. Attend to claims enquiries and feedback, maintain positive relationship with all customers, brokers, providers etc. 

8. Handles incoming and outbound queries from Customers and/ or Brokers.
9. Proactively apply claims policies and procedures including Chubb's policy in relation to fraud, salvage, recovery, cost containment and complaints.
10. Attends administrative activities (team huddles, trainings)
11. Performs other related duties as may be assigned by the supervisor/s
12. Immediately report potentially and confirmed Fraudulent cases, Compliance and Privacy Breaches to Management chain.
13. Nominate two process improvement ideas annually for SME and TL endorsement to the Manager.

Experience:

• Good analytical skills and strong attention to detail.

• Demonstrated strong communication skills (written and verbal) and interpersonal skills to be capable of dealing with all levels of Chubb personnel as well as claimants and brokers. 

• Ability to organize work effectively and methodically and as a team and adjust to change driven by business needs. 

• Ability to maintain a high level of quality in all claims administration activities ensuring the settlement times and complaint levels are minimized.

• Sound knowledge of claims administration procedures and related systems.

• Possess strong customer service behaviour.

Qualifications:

• Tertiary Qualified or minimum 2-3 years similar work experience 

• Claims Insurance background (is preferred)

BGC, Taguig | On-site | Blended Ops (Voice + Back Office)

Full-time | ₱25,000 – ₱0,000 + ,000 Sign-On Bonus

Target Start Date: September 1

Join a leading healthcare account where your expertise in claims processing and customer support will make a real impact. We're offering not only a competitive salary package but also a ,000 sign-on bonus to welcome you aboard

What You'll Do

• Handle claims processing tasks with accuracy and efficiency.
• Manage inbound and outbound calls, plus back-office responsibilities.
• Provide exceptional care and support to healthcare customers.
• Ensure timely and proper resolution of cases in line with compliance standards.

What We're Looking For

• Minimum Education: High School Graduate (SHS & College graduates welcome).
• Experience:
• At least 18 months of BPO international voice experience.
• Claims processing / Care management background is a big plus.
• Comfortable with voice + back-office tasks.
• Strong communication skills and keen attention to detail.

Compensation & Benefits

• Salary Package: ,000 – ₱4 00 (depending on experience).
• ,000 Sign-On Bonus
• Safe offer benchmark: +18% of your current salary.
• 20% Night Differential
• HMO coverage after 6 months (for you and your dependents).
• Walk-in applications accepted in BGC, Taguig.

Additional Details

• Location: BGC, Taguig (on-site).
• Operations Type: Blended (back-office + inbound/outbound calls).
• Schedule: Night shift.
• Start Date: September 1.

Job Types: Full-time, Permanent

Pay: Php25, Php40,000.00 per month

Benefits:

• Additional leave
• Company Christmas gift
• Health insurance
• Life insurance
• Opportunities for promotion
• Paid training
• Promotion to permanent employee

Experience:

• BPO: 1 year (Required)

Work Location: In person

Qualifications

• Bachelor's degree or equivalent in health care or medicine
• OPEN FOR FRESH GRADUATE
• 2+ years of relevant experience
• Proficient in Microsoft Excel
• Strong quantitative financial skills

Job Description:

• Ensure that the staffing requirements are met and the highest quality of applicants is maintained for administrative, professional, and management personnel
• Work with the Recruiters and various Hiring Managers/Business Units for both local and global for hiring needs (project scoping, hiring needs assessment)
• Maintain appropriate, timely tracking of candidates as they move through the recruiting process and ensure these movements are reflected in Workday in a timely manner.
• Candidate dispositioning in Workday and in providing feedback to candidates.
• Schedule and administer/proctor tests and manage assessment results
• Discuss Job Offer and Company profile to identified candidates
• Work with the Manager on process improvement and process excellence projects.
• Workday requisition and candidate sanitation, adhering to end-to-end Workday recruiting standards
• Generate recruitment related reports and analysis.
• Build sustainable relationships and trust with candidates, Hiring Managers and other people involved in hiring through open and interactive communication; Work closely with them to drive innovative solutions to meet business needs.