Claims Adjuster

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Conduct thorough investigations, evaluations, and resolutions of travel medical claims from start to finish

• Adjudicate benefits in accordance with policy terms and legal requirements

• Process invoices utilizing cost-containment networks

• Provide clear and timely updates to customers, providers, and partners regarding claim status

• Ensure comprehensive documentation in the claims system, maintaining high-quality files

• Evaluate the necessity for medical management and escalate cases as needed

• Process bills in line with statutory regulations and internal controls

• Detect potential fraud, waste, or abuse and collaborate with the investigative team

• Maintain exceptional written and verbal communication with customers throughout the claims process

• Undertake additional responsibilities as required to support the team and its customers

• Establish clear and relevant goals, consistently exceeding expectations

• Prioritize tasks that enhance outcomes for travelers and the organization

• Foster strong relationships with customers, providers, and partners to promote a humanity-centered travel insurance experience

⛳️ Requirements

• Demonstrated experience managing travel insurance claims, including intricate domestic and international scenarios

• Current (or the ability to acquire) state adjuster licensing

• Proficient writing, negotiation, communication, organization, reporting, data gathering, reserving, brainstorming, and research skills

• Comfortable working with data, forms, spreadsheets, and policy documentation

• Must possess (or be eligible to obtain) state adjuster licenses for adjudicating travel insurance claims

• Comply with state insurance regulations

• Fulfill continuing education requirements related to state licenses

• Experience in a startup or rapidly growing environment is advantageous

• Proficiency in English is essential; additional language skills are preferred to support the global membership base

🏝️ Benefits

• Competitive salary and performance-based incentives

• Comprehensive health and wellness programs

• Opportunities for professional development and growth

• Flexible work arrangements to support work-life balance

• A collaborative and inclusive work environment