Senior Manager, Claims Technical Management

FIND YOUR 'BETTER' AT AIA

We don’t simply believe in being ‘The Best’. We believe in better - because there’s no limit to how far ‘better’ can take us.

We believe in empowering every one of our people to find their 'better' - in the work they do, the career they build, the life they live and the difference they make. So that together we can support even more people - including our own - to live Healthier, Longer, Better Lives.

If you believe in better, we’d love to hear from you.

About the Role

The Senior Manager, Claims Technical Management is responsible for ensuring that processing and releasing of claims are effectively and efficiently managed. Processes should be properly established for all claim types. Oversees claims processing with a view of providing high quality service across all claims following our customer-focused, digital first approach.

Roles and Responsibilities:

Performance management

• Ensure that claims are processed in a timely and judicious manner; with clear, concise, and customer-friendly communications.
• Cognizant of data governance, data privacy and relevant regulations in ensuring continuous, timely and effective processing of claims transactions.
• Plans, schedules, supervises and controls work operations within the team to ensure that the claims volume can be adequately supported.
• Reviews and decides on complex cases referred by claim assessors within authority limit in accordance with proper claims practices.
• Serve as claims fraud manager. Identify and report potential fraudulent claims.
• Closely monitor TATs and SLAs, identify process bottlenecks and recommend improvements accordingly.
• Plans and recommends administrative and operational changes to further improve processing and servicing and to maximize manpower utilization.
• Reviews, edits, approves and/or signs letters, memos and documents and other correspondence to the policy owner, agent or other concerned parties pertaining to processing of Claims transactions.
• Conduct closed-file reviews to assess the performance of each claim assessor and recommend the appropriate action for each.

Customer and Distributor Satisfaction

• Resolve customer and distributor complaints, offer viable courses of action and/or recommend handling of exceptional cases for management approval.
• Collaborate with distributors and conduct training sessions as deemed necessary.
• Respond to email inquiries and escalations in a timely and courteous manner.

People management and development

• Conduct regular conversations with team members to provide feedback on performance, discuss strengths and areas for improvement, and address concerns.
• Evaluate job performance of employees for probationary and/or regular appointments and for performance management purposes.
• Conduct learning sessions to upskill and cross-skill team members.
• Define and discuss performance goals for each team member.
• Drive action plans to improve team engagement.
• Assist the Head of Claims and Policy Benefits in developing and implementing action plans in accordance with set priorities.

Risk management

• Participate in analysis and recommendations of cases referred to the Executive in charge for decision on requests for reconsideration and exception cases.
• Review claims processes to identify risk areas and recommend improvements.
• Develop and update the claims adjudication manuals according to new products and developments.

Projects and initiatives

• Provide process owner expertise to various initiatives of the Company through attendance to requested meetings, email and phone consultations and the like.
• Participate in and support automation initiatives by providing inputs, defining requirements and testing enhancements.
• Perform other responsibilities and duties periodically assigned by superior o meet operational and/or other requirements.

Minimum Job Requirements:

• College graduate of any course.
• With at least five (5) years’ experience in managing a team of claim assessors.
• With experience in automation and process improvement initiative.
• With keen attention to details.
• Excellent people skills
• With excellent written and oral communication skills in both English and Filipino.
• Must be proficient in MS Office applications.

Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.

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