32 Insurance Claims Examiner 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

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

Job Overview

We're seeking a highly organized and fluent English-speaking contractor with prior experience handling auto insurance accident claims within the U.S. system. This role involves end-to-end management of all insurance-related incidents for our company vehicles—filing claims, communicating with insurers and third parties, managing timelines, and maintaining detailed records.

Responsibilities

· Manage all insurance claims related to company vehicle accidents (first-party and third-party).

· Liaise with U.S. auto insurance companies, adjusters, and third-party insurers.

· Submit and track claims documentation; ensure timely processing and follow-up.

· Maintain accurate and organized records of all incidents and claims.

· Coordinate with internal departments to gather necessary information.

· Monitor the status of open claims and escalate when needed.

· Help develop processes and systems for claims management and reporting.

· Track successful claim recoveries and contribute to reporting performance outcomes.

Skills & Qualifications

· Proven experience handling U.S. auto insurance claims or similar insurance industry experience (e.g., claims processor, claims adjuster, claims coordinator).

· Excellent English communication skills, both written and spoken.

· Strong attention to detail and ability to manage multiple claims simultaneously.

· Highly organized and self-driven, with a proactive problem-solving mindset.

· Comfortable working independently and collaborating remotely with a U.S.-based team.

· Available to work U.S. daytime hours (California time zone).

· Familiarity with U.S. insurance processes and terminology.

· Experience working with U.S.-based clients or companies preferred.

· Background in repossession, towing, or auto transport industries is a plus.

· Proficiency with tools like Microsoft 365, Excel, or claims management platforms.

Compensation & Benefits

· $200–$250/week based on experience.

· Bonus structure tied to successful insurance claim recoveries.

· Flexible work schedule within the required time window.

· Long-term opportunity with room for growth.

· Paid time off

Job Type: Full-time

Pay: Php45, Php57,070.00 per month

Benefits:

• Paid training

Experience:

• auto insurance claims: 1 year (Preferred)

Work Location: Remote

Job Summary:

An Insurance Claims Agent is responsible for investigating, evaluating, and processing insurance claims filed by policyholders. The role ensures claims are handled promptly, fairly, and in compliance with company policies and legal regulations. The agent acts as the primary point of contact for claimants throughout the claims process.

Key Responsibilities:

• Receive, review, and process new insurance claims in a timely manner.
• Investigate claims by contacting policyholders, witnesses, and other relevant parties.
• Collect and evaluate documentation such as police reports, medical records, and repair estimates.
• Assess damage and determine coverage based on policy terms and conditions.
• Negotiate settlements with claimants or third parties, when applicable.
• Maintain accurate records of claim status, decisions, and correspondence in internal systems.
• Collaborate with underwriters, legal teams, and other departments as needed.
• Identify potential fraudulent claims and refer them to the appropriate investigation unit.
• Communicate claim decisions clearly and professionally to customers.
• Ensure compliance with industry regulations and internal standards.

Qualifications:

• Bachelor's degree holder
• Previous experience in insurance claims, customer service, or related field is advantageous.
• Knowledge of insurance policies and procedures.
• Strong analytical and investigative skills.
• Excellent communication and negotiation skills.
• Ability to handle sensitive and confidential information.
• Proficiency in using claims management software and standard office applications.

Job Type: Full-time

Pay: Up to Php25,000.00 per month

Work Location: Remote

At Limitlessli we specialize in recruiting, hiring, and managing high-caliber remote staff. Leveraging our extensive global network, we connect clients with highly qualified professionals, offering tailored services to meet our clients' unique business needs.

Are you detail-orientated and skilled in data entry?  Do you thrive in a fast-paced environment?  We currently have an opportunity for a meticulous and efficient Insurance Claims Assistant to join our team.

In this position you will play an important role in our client's claim management process, ensuring the accurate and timely entry of new Workers' Compensation claims into their claims management system.  Your keen eye for detail and exceptional data entry skills are required to ensure the integrity and efficiency of their claims processing.

This position is remote and offers you the flexibility of working from home.

• Receive and review new claims documentation for completeness and accuracy
• Enter new claims information into a claims management system
• Verify the accuracy of data entered against source documents
• Maintain electronic and physical records of all claims entered
• Perform other administrative tasks related to claims processing as required

• Exceptional verbal and written communication skills in English
• Previous experience in data entry or administrative roles preferred
• Strong attention to detail and accuracy
• Proficient in MS Office and other data entry software
• Excellent organizational and time-management skills
• Ability to handle confidential information with discretion

• Senior High School Diploma or equivalent

Industry standards applicable to the state depending on work experience and level of expertise.

US Eastern Standard Time (EST) – 9am to 5pm

We embrace the flexibility and convenience of a remote working environment, and you will collaborate with an international team while contributing to our growing business, all from the comfort of your home.

You will need to have some essential tools – a reliable computer and noise-canceling headset, a second monitor for enhanced productivity, and a stable internet connection. You'll also be required to have a backup internet connection, ensuring that you're well-equipped to complete your work seamlessly.

Don't miss out on this opportunity – apply now and become a valuable member of the Limitlessli team  If you're interested in what you have read, then we invite you to take the next step and submit your application.

Accuracy meets efficiency—be the difference in every claim's journey
at Smartsourcing, a 4-Time Best Company to Work For

Hi We're
Smartsourcing
, and we're looking for a
full-time
,
onsite Vehicle Claims Adjuster
to keep cases moving, documents in order, and deadlines on point. You'll handle claims, recoveries, and logistics tasks with precision—ensuring accuracy, compliance, and seamless coordination every step of the way. Here, your eye for detail and knack for keeping workflows on track will help deliver the gold standard of service our clients expect.

Where?
JEG Tower, Archbishop Reyes, Corner Acacia St., Barangay Kamputhaw, Cebu City, 6000 Cebu

The
Vehicle Claims Adjuster
is responsible for delivering high-quality operational support across Recoveries, Claims, and Logistics workflows. This role ensures timely and accurate processing of cases, coordination of documentation, follow-ups with internal and external stakeholders, and adherence to company policies and compliance standards. The position plays a vital role in maintaining efficiency, accuracy, and service excellence throughout the claims lifecycle and associated logistics activities.

Key Responsibilities

Claims Support

• Monitor and manage the
  Claims Inbox
  and
  Overflow
  queues, ensuring timely allocation and response.
• Process and assess
  Non-Fault
  claims and cases in
  Caspar
  .
• Handle
  Caspar Remaining Requests
  , ensuring all outstanding requirements are addressed.
• Conduct
  Rego Chase
  follow-ups (checked and contacted) and obtain
  Rego papers
  for claim files.
• Support documentation for
  POE bundling
  and
  hearing preparation
  where applicable.

Recoveries Support

• Conduct
  Assessment of Recoverable in WA
  and other regions as needed.
• Complete and review
  Legal Checklists
  .
• Undertake
  Outbound
  activities for reduced settlements and legal file reviews.
• Prepare and process
  Witness Statement Affidavits
  .
• Process
  Recoveries Emails
  and perform follow-ups (
  Email Left
  ).

Logistics Support

• Issue and follow up on
  Collection Notes
  .
• Process
  On Hire
  requests and update email notifications (
  On Hire Email Left
  ).
• Conduct
  Post Hire QA
  and track
  Total Post Hire
  volumes.
• Monitor and action
  Remaining Post Hire Targets
  .
• Chase
  Client Outstanding Documents
  .
• Manage
  Manila Task List
  and resolve
  Task List Outstanding
  items.

TPD & Multi-Stream Support

• Perform
  TPD Chase
  activities, both for files checked by other handlers and files contacted directly.
• Obtain
  Claim Numbers
  and track
  TPD Success Rates
  .
• Coordinate
  Delivery Sent
  confirmations.
• Manage
  Change File Handler
  requests.

General & Ad Hoc Duties

• Provide
  ad hoc operational support
  across Claims, Recoveries, and Logistics as required.
• Participate in
  training
  and skill development programs to stay updated on processes, systems, and compliance standards.
• Maintain accurate records in accordance with company and regulatory requirements.

Requirements

Key Skills & Competencies

• Strong organisational skills with the ability to manage multiple workflows simultaneously.
• High attention to detail and accuracy in data entry and documentation.
• Effective communication skills (written and verbal) for internal and external interactions.
• Ability to work under pressure and meet deadlines in a fast-paced environment.
• Proficiency in case management systems, email platforms, and Microsoft Office Suite.
• Problem-solving skills with a proactive approach to resolving issues.

Qualifications & Experience

• Previous experience in claims processing, recoveries, or logistics within the insurance or legal services sector preferred.
• Experience in administrative or operational support roles with high-volume workflow management.
• Understanding of insurance claims procedures, recoveries processes, and logistics coordination (advantageous).
• Training in compliance, data handling, or legal document preparation (desirable but not mandatory).

Benefits

Step Into the Smartsourcing Experience

Smartsourcing was created with one mission: to change lives. We're here to ensure that businesses flourish and, just as importantly, that every member of the crew is inspired, supported, and set up to thrive. For the fourth year running, we've been recognized as one of HR Asia's Best Companies to Work For. This award isn't just a title—it's a testament to our commitment to making Smartsourcing an incredible place to build a career.
Why You'll Love Working Here

At Smartsourcing, we believe the best work comes from people who feel seen, heard, and valued. That's why we're all about fostering an environment where you can be your true self. We take pride in being certified as a Great Place to Work, because we know that when you love where you work, extraordinary things happen. Here's just a glimpse of what we offer:

• Fixed weekends off
• 5-day Christmas Leave
• HMO coverage for you and your dependent/s from Day 1 of employment
• Group life insurance from Day 1 of employment
• Free lunch + soft breakfast every day
• Free coffee every day (latte, americano, or cappuccino) made by our in-house barista
• For the night shifters, additional NIGHT DIFF
• Sports wellness clubs including hiking and free-diving
• Subsidised gym membership at Anytime Fitness
• Engagement bonuses
• Over-the-top monthly, quarterly, and annual performance bonuses
• Exclusive discounts in selected restaurants and merchants
• Themed BFFs, monthly knockoffs, summer parties
• Community give-back programs and personal development workshops
• And so much more

We're not just another outsourcing company. We're building something that actually matters here – a place where good work meets good culture.

Your next career move starts here—step in, stand out, and make an impact where precision and performance truly matter. Join Smartsourcing.

• Documents specific claims by completing and recording forms, reports, logs, and records.
• Analyzes insurance claims to prevent fraud.
• Prepares reports by collecting, analyzing, and summarizing information.
• Resolves claims by approving or denying documentation, calculating benefits due, and determining compensation settlement.
• Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations.
• Maintains quality customer service by following customer services practices and responding to customer inquiries.

Role Overview:

As the Insurance Claims Assistant Manager, you will play a pivotal role in managing and overseeing all aspects of insurance claims related to our ride-hailing operations. You will be responsible for ensuring timely and accurate processing of claims, maintaining compliance with insurance policies and regulations, and implementing effective strategies to minimize claim-related risks. Additionally, you will lead a team of Insurance Claims Assistants, providing guidance, training, and support to ensure high performance and productivity.

Job Description:

• Lead the strategic evaluation and management of life insurance policies to ensure optimal coverage and risk mitigation.
• Direct the review, processing, and administration of insurance applications to guarantee compliance with all regulatory and company standards.
• Collaborate with the other departments to investigate complaints, correct errors, and ensure adherence to industry regulations and standards.
• Serve as the primary point of escalation for both procedural and technical issues, coaching staff on effective resolution strategies.
• Monitor and track team performance, providing timely feedback to promote productivity and efficiency.
• Foster clear and prompt communication with customers to ensure high-quality service regarding claims and/or inquiries.
• Ensure comprehensive knowledge of the intricacies and compliance standards of key benefit management programs, guiding the team in maintaining these standards.
• Drive process improvements within the team to enhance efficiency, client experience, and risk controls.

Qualifications:

• Bachelor's degree
• Experience in managing a team
• Up-to-date knowledge regarding insurance and industry practices
• Acts as a Subject Matter Expert regarding insurance claims
• Good communication and organizational skills
• Willingness to start ASAP
• Willingness to work onsite in Marcos Highway, Antipolo City