Job Profile

Outsourcing Claims Processing & Departments in the Philippines

Experts in insurance claims outsourcing in the Philippines

Exploring your options for outsourcing claims processing? You’re in the right place. Accidents and illnesses can happen at any time of the day or night, which is why most insurance companies offer a 24-hour claims service. But, as you know, running a local 24-hour contact center is expensive, which is why outsourced insurance claims processing is so appealing.

The Philippines is a major hub for offshore insurance claims processing, and customer contact centers in general. Filipinos make wonderful claims processors, with their exceptional English language skills, coupled with their gentle respect for customers.

Indeed, Filipinos are so well suited to the role that insurance companies have based their claims processing teams in the Philippines for many years. That’s good news for you, because it means there’s an abundance of suitable candidates ready to join your team.

The common types of insurance claims being processed in the Philippines are:

  • Medical or health insurance
  • Car insurance
  • Life insurance

Other less common insurance types in offshore claims processing are:

  • Mortgage insurance
  • Travel insurance
  • Property damage or home contents insurance

Claims processing is a large unit in insurance operations (second only to the sales unit) involving review, investigation, adjustment and remittance of an insurance claim.

In some companies, full-cycle claims processing may not be done by a single person. For example, review and investigation may be assigned to junior processors, then adjustment and remittance assigned to senior processors. For this reason, claims processors work best in teams, reporting to an experienced team leader for advice and escalation.

Claims processing skills and experience

Many of the skills a candidate needs to be a good claims processor are transferable from other customer service and contact center roles.

The most important skills for claims processors are:

  • Excellent English communication skills (both speaking and writing)

  • Previous claims processing experience, or strong customer service experience in another field

  • Excellent attention to detail

  • Compassion for customers, while also adhering to company policies

In hiring medical or health insurance claims processors, most employers prefer candidates who are already familiar with medical and billing terms, because this speeds up the onboarding process.

Whereas for car and life insurance claims processors, there are fewer technical terms, so no previous industry experience is necessary. During their introductory training, new employees are quick to come up to speed with industry terms and processes. Claims processors are categorized by level, for all types of insurance claims:

Junior – has 1-2 years of work experience as a claims processor
Intermediate – 2-3 years of work experience as a claims processor
Senior – 3+ years work of experience as a claims processor

Claims processing tools

Most insurance companies develop their own tools and software for claims processing. The tools usually include a secure database or customer relationship management (CRM) software for storing their customers’ sensitive data such as personal information, health information and credit history.

While each company has their own unique system, interface, and data entry conventions, the skills for using such systems are transferable, so you’ll find that new employees pick up the differences with just a small amount of training.

Save up to 70% on labor and occupancy costs

Because living costs are so low in the Philippines, labor and occupancy costs are low too. We can employ and accommodate fully qualified, very experienced claims processors for your team in the Philippines for up to 70% less than you’d pay in your local employment market. So really, outsourcing claims processing to the Philippines just makes good business sense.

Tips for employing Filipino claims processors

  • It takes 4-6 weeks to hire a claims processor in the Philippines.
  • Full-cycle claims processors usually have intermediate to senior level experience, with higher salary expectations.
  • For car and life insurance claims processing, the industry terms are easy to learn, so you’ll find that someone with customer service experience can get the job done, even without prior knowledge of insurance.
  • Performance-based incentives are common and highly encouraged in this type of work. Your company policy should be to reward an employee’s performance when they exceed your expectations.
  • Claims processors usually work within a team, with a team leader being a subject matter expert and handling customer escalations.

Top 5 universities for claims processors

Claims processors do not tend to come from a specific degree or university. You can hire a fresh graduate (of any degree) and, provided they have good English communication skills and the right attitude, you can train them and they’ll excel in the role.

In fact, a university degree is not necessary to be a good claims processor; prior experience in general customer service roles is often enough.

Most schools and universities in the Philippines produce highly employable graduates from many different degrees. The top universities are:

University of the Philippines
University of Santo Tomas
Polytechnic University of the Philippines
De La Salle University
Ateneo de Manila University

The Commission on Higher Education (CHED) however have not yet started tracking graduates specific in this field.

Sample claims processor profiles

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SKILLS

  • Gathering and interpreting data from a variety of sources
  • Auditing new business, billing and enrollments, and renewing groups/companies
  • Auditing quotes in Qube System

RECENT ROLES

  • Data Analyst – Claim Processor
  • Quality Analyst
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SKILLS

  • Capable of total nursing care such as assessment, planning, implementation as well as evaluation
  • Competent in taking vital signs, administration of medications, documentation
  • Knowledge in medical terminology
  • Quality patient care
  • Ability to listen and empathize with the customer and acknowledge their concerns
  • Can handle queries very well with nice interpersonal skills

RECENT ROLES

  • Claims Auditor
  • Pharmacy Benefit Analyst
  • Transaction Specialist
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SKILLS

  • Certified Medical Coder
  • Registered Nurse
  • Medical Transcription Editing with ASR Program
  • Typing Speed: 53 wpm
  • Computer Proficiency including Microsoft: PowerPoint, Word, and Excel.

RECENT ROLES

  • Claims Relations Officer
  • Claims Quality Auditor
  • Medical Language Specialist

Want a claims processor – or team of claims processors – in the Philippines?

Since our inception in 2006, MicroSourcing has become one of the biggest managed operations providers in the Philippines. With over 4,000 employees, 7 delivery centers and close to 200 clients, we can help you build a dedicated team in the Philippines, regardless of the roles and level of specialization you require. We have approximately 4,500 claims processors in our candidate database, and we’ve employed close to 100 claims processors for our clients since 2010.

Work with the experts in insurance claims outsourcing. Call today or send us an email to discuss your company’s claims processing needs. You’ll have your outsourced claims processor(s) up and running in as little as 4 weeks.

Our Outsourcing Business Consultants will discuss with you what roles can be outsourced, saving up to 70% on employment and housing costs. Once you identify your staffing requirements and complete our Job Description template, you'll receive an analysis of the relative employment costs at different levels of experience in your industry.

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