In this position you will…
…lead end-to-end claims operations and partner management to deliver timely, fair, and compliant claim outcomes. Responsibilities include overseeing claims intake, assessment, and settlement; monitoring third-party administrator (TPA)/vendor performance against SLAs; driving continuous improvement to reduce turnaround time and leakage; and ensuring a consistently high customer experience across all touchpoints.
You will be responsible for…
▪Own end-to-end claims operations (FNOL to settlement) and ensure consistent application of claims handling standards and customer commitments.
▪Manage and monitor claims TAT, quality, and compliance KPIs; perform root-cause analysis and implement corrective and preventive actions.
▪Oversee investigations and complex/escalated claims, ensuring appropriate documentation, fraud controls, and sound decisioning.
▪Partner with underwriting, product, customer service, and finance to improve claims processes, customer communications, and policy/wording interpretation.
▪Manage TPA/vendor performance, resourcing, and capacity planning; conduct regular operational reviews and drive SLA adherence.
▪Handle claim complaints and regulatory/customer escalations, ensuring resolutions are timely, well-documented, and aligned to contractual and regulatory requirements.
▪
Produce regular claims performance reporting and dashboards (e.g., volumes, TAT, approval/decline rates, leakage, recovery, complaints, and SLA adherence), highlighting trends, risks, and improvement opportunities for stakeholders.
For you to be successful…
Adaptable
▪Looks to understand bigger picture rationale for changes and adapts in a flexible and nimble manner.
▪Takes a test and learn approach, integrates new information to determine best course of action.
Communication
▪Effective and articulate communicator actively and respectfully listens to and synthesizes others’ perspectives
▪Keeps relevant people accurately informed and up-to-date of both positive and potentially negative information.
▪Appreciates feedback and provides timely specific feedback in return.
Customer focus
▪Responds quickly and effectively to new customer ideas and request.
▪Actively seeks to understand customer feedback and needs and uses this in decision making and solutioning.
Collaborative
▪Partners with a range of people to create trust, and co-create and deliver mutually beneficial outcomes.
▪Develops collaborative and dynamic working relationships to achieve the best possible outcomes.
▪Resolves disputes using a range of tactics to prioritize positive outcomes.
You will require the following qualifications and skills
▪Bachelor’s degree in Business, Insurance, Finance, or a related field.
▪Minimum 5+ years of insurance/protection claims experience, including managing complex or escalated claims and/or supervising a claims team.
▪Strong knowledge of end-to-end claims lifecycle management, policy/coverage interpretation, reserving basics, and settlement negotiation.
▪Experience managing third-party administrators (TPAs) and external vendors, including SLA/KPI governance, quality audits, and operational reviews.
▪Working knowledge of fraud detection/controls and claims investigation practices; able to support suspicious claim triage and escalation.
▪ Strong understanding of regulatory and contractual requirements relevant to claims handling, complaints management, and data privacy.
▪ Excellent stakeholder management, communication, and influencing skills, with a track record of resolving escalations and driving service improvements.
▪Strong analytical and reporting skills; proficient in Excel and PowerPoint (Power BI and/or SQL is a plus) to produce claims dashboards and insights.
▪Fluent in Tagalog and English; able to write clear claim communications and present performance updates to internal and external stakeholders.
Claims Manager • Manila, National Capital Region, Philippines
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