Operations/Claims Manager

Operations Claims Manager – Manila

Job Description and Requirements:

• Graduate of Bachelor's Degree
• Minimum 5 years experience in Health Insurance industry as Operations Manager; BPO exposure is an advantage.
• Strong background in initiating, developing, implementing and monitoring administrative/management activities to position TCAP with TKC
• Strong leadership, team development, coaching and mentoring skills; proven track record in building high performing teams
• Change agent capable of guiding organization through change management initiatives
• Strategic mindset to set corporate directions and align goals with business plans
• Superior judgment, negotiation and decision-making abilities
• Strong ethics and integrity
• Strong analytical skills; able to translate strategic vision into operational models
• Effective communicator at all levels (oral and written)

Duties and Responsibilities:

1. Organizational Effectiveness: manage operational functions and improve Corporate Services (HR, IT, Finance) through coordinated function improvements; drive long-term operational excellence; provide consulting on business structure and growth
2. Develop strategic plans and monitor metrics; improve systems, processes and policies; enhance management reporting and information flow
3. Oversee TCAP financial management, budgeting and controls; identify key activities and priorities; implement and communicate operational strategies
4. Organizational Leadership: contribute to planning and strategy; liaise with legal counsel; oversee policies and business continuity; ensure adherence to professional management standards
5. Regulatory Compliance: ensure TCAP practices comply with licensure, accreditation and legal requirements
6. Budgeting and Financial Planning: manage annual budgeting and cash flow; develop long-range forecasts
7. General Management: planning, policy development, staffing, performance management, and ensuring alignment with financial guidelines
8. Claims Manager Responsibilities: claims processing, data integrity, performance targets, HIPAA compliance, coordination with departments, and management reporting

Customer Success Manager – Claims Operations

Location: Makati City, NCR

Salary: ₱1,200,000 – ₱2,400,000

Job Description:

• Lead a team of 10–15 Customer Service Partners; oversee daily claims processing for US-based clients
• Escalation point for complex claims and shipment issues; monitor performance metrics
• Coach and address underperformance; collaborate with internal stakeholders
• Ensure consistent use of Microsoft Dynamics; drive process improvements and change management
• Generate performance reports to support decisions

Qualifications:

• 3–5 years in customer success, claims, or order management in manufacturing/B2B
• Experience managing direct reports; problem-solving and proactive communication
• Proficiency in Microsoft Dynamics or similar CRM
• Experience handling escalations in high-volume environments
• Ability to adapt to process changes and cross-functional collaboration

Training & Tools: Basic Dynamics training and ~3 weeks onboarding; tools include Microsoft Dynamics and internal dashboards

CSR (Claims Processing – Healthcare) – 30k Sign-On Bonus

Location: BGC, Taguig (On-site)

Salary: ₱25,000 – 40,000 + ₱1,000,000 Sign-On Bonus

What You’ll Do:

• Handle claims processing; manage inbound/outbound calls and back-office tasks
• Provide high-quality customer care; ensure timely resolution in line with compliance

What We’re Looking For:

• High School graduate (SHS); college graduates welcome
• 18+ months BPO international voice experience; claims processing/healthcare background is a plus
• Strong communication and attention to detail
• Salary range and sign-on bonus as stated

Others: walk-in applications accepted; night-shift operations

Insurance Claims – Senior Manager

Location: Makati City

Salary: ₱1,200,000 – ₱2,400,000

Role:

• Senior manager for medical/claims operations; leadership and oversight of non-life/medical claims
• Experience with HMO or insurance preferred; work onsite in Makati; start ASAP

Qualifications:

• 10–15 years in claims management; HMO/insurance background preferred
• Strong knowledge of claims management and HMO processes; leadership experience

Claims Manager

Location: Makati City

Role:

• Lead end-to-end claims processing; ensure compliance with Philippine regulations
• Manage a team; build client relationships; improve efficiency
• Collaborate with underwriting, actuarial, and legal teams

Qualifications:

• Bachelor’s degree in Insurance/Business/Risk Management
• ≥5 years in claims management (insurance/healthcare)
• Understanding of Philippine insurance regulations; leadership skills
• Proficient in MS Office and claims systems

Other Roles Listed:

• Team Manager – Disability Insurance Claims (TAGUIG/DAVAO)
• Claims Manager – Non-Life (Kaiser International Healthgroup, Makati)
• Claims Assistant Manager ( ride-hailing operations )
• Insurance – Claims, Senior Manager (Manila Bankers Assurance, Makati)

Note: Some postings indicate region-based applicant restrictions.

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