This Claims Analyst is responsible for the overall review, assessment, and decision of claims.
Position Responsibilities:
Determine eligible benefits based on documents submitted and policy provisions.
Adjudicate claims and determine corresponding recommendation or decision within prescribed approval limits and within the defined turnaround time.
Ensure accurate benefit payouts in accordance with the policy details, laws and regulations.
Discuss claim decisions with distributors whenever necessary.
Escalate possible fraudulent claims to the Team Lead and recommend appropriate action.
Required Qualifications:
At least three (3) years experience in life and health claims
Graduate of any four-year course; a medical course or legal background would be an advantage
With industry certifications or exams passed (ALMI, etc.)
Able to communicate clearly and effectively with peers and higher management
Able to assess complex medical claims
Can decide on complex medical claims based on information gathered, product provisions and applicable insurance laws
Able to clearly explain the rationale behind claim decisions
Can identify and recommend improvements to systems and processes
When you join our team:
We’ll empower you to learn and grow the career you want.
We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words.
As part of our global team, we’ll support you in shaping the future you want to see.
About Manulife and John Hancock
Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html.
Manulife is an Equal Opportunity Employer
At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.
It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact hr@manulife.com.
Working Arrangement