Company Nurse

About the role

We are seeking a dedicated and compassionate Nurse to join MAAGAP Insurance Inc. in Makati City, Metro Manila. This is a full-time position that plays a vital role in the appropriate evaluation, processing, and settlement of Accident & Health Claims.

ESSENTIAL FUNCTIONS:

1. To ensure that all A&H Claims are properly evaluated and processed within the set turn-around time
2. Prepare insurance claim forms or related documents and revise them for completeness
3. Checks data for recording errors
4. Prepares documentation for contracts, transactions or regulatory compliance
5. Enter claims information into database system
6. Calculates amount of claim and costs of goods or services
7. Transmits claims for payment for further investigation
8. Contact insured or other involved persons to obtain missing information
9. Reviews insurance policy to determine coverage
10. Reviews customer insurance information
11. Provide customer service, such as limited instructions on proceeding with claims or referrals to contractors
12. Explains regulations, policies and procedures
13. Issuance of Order of Payment
14. To monitor and implement control procedures of A&H Claims
15. To ensure the correctness of claims documents/booking in the system
16. To ensure that claims processing and administration is cost effective and efficient
17. Performs as Company Nurse and OSH Member

1. Bachelor of Science in Nursing (BSN) or equivalent nursing qualification
2. Valid Nursing License and current registration with the Philippine Nurses Association (PNA)
3. Minimum of 2-3 years' experience in non life insurance
4. Strong knowledge of occupational health and safety standards and regulations
5. Excellent communication and interpersonal skills with the ability to interact effectively with employees at all levels
6. Proficiency in basic life support (BLS) and first aid certification
7. Ability to maintain confidentiality and handle sensitive health information with integrity
8. Strong organisational and time management skills
9. Computer literacy and ability to manage health records and documentation systems