Claims Manager

1 week ago

Manila, National Capital Region, Philippines Nezda Global Full time ₱104,000 - ₱130,878 per year

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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