
Claims Manager
1 week ago
About the Role
This is a hybrid leadership role based in Makati, where you'll manage a team of claims assessors, ensure operational excellence, and drive automation and fraud prevention initiatives across claims processing.
Key Responsibilities
- Oversee timely, accurate, and policy-compliant claims processing
- Handle complex claims escalations and approvals within authority limits
- Lead closed-file reviews and ensure quality standards
- Monitor SLAs, eliminate process bottlenecks, and implement improvements
- Act as fraud manager — flag and escalate suspicious claims
- Handle distributor training and customer complaints/escalations
- Coach and evaluate assessors, set KPIs, and conduct upskilling sessions
- Support automation, risk audits, and policy documentation updates
- Collaborate on cross-functional projects as the claims SME
Must-Have Qualifications
- Bachelor's degree (any field)
- At least
5 years of experience managing a claims assessment team - Strong track record in process improvement and automation initiatives
- Fluent in English and Filipino (written and oral)
- Proficient in Microsoft Office (Word, Excel, Outlook, etc.)
Good-to-Have
- Background in life or health insurance
- Experience handling fraud detection in claims
- Comfortable handling high-volume, high-risk claims operations
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