Claims Manager

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.

• →Conduct regular conversations with team members to provide feedback on performance, discuss strengths and areas for improvement, and address concerns.
• →Evaluates job performance of employees for probationary and/or regular appointments and for performance management purposes.
• →Conduct learning sessions to upskill team members.
• →Define and discuss performance goals for each team member.
• →Drive action plans to improve team engagement.
• →Assist the Head of Claims in developing and implementing action plans in accordance with set priorities.
• →Build strong relationships with Distribution, Agency, Customer Service, Compliance, Finance, Technology, Operations, Marketing, and other business units.
• →Assist and provide insights for cross functional and management reporting.
• →Performs other responsibilities and duties periodically assigned by superior o meet operational and/or other requirements.

• 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 cases referred by claim assessors within authority limit in accordance with proper claims practices.
• Closely monitor TATs and SLAs, identify process bottlenecks and recommend improvements accordingly.
• Act as the primary escalation and decision-making point for complex operational and customer issues.  This includes resolution of customer complaints, offer viable courses of action and/or recommend handling of exceptional cases beyond own authority for management approval.
• 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.

• Participates 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
• Perform and oversee adherence to control standards as defined in the control framework (including but not limited to eGRC, FSCA, ICFR/non-ICFR controls, AML requirements, and operational risk management).
• Monitor suspense accounts, unresolved transactions, operational exceptions, and control deficiencies.
• Own and maintain policies, procedures, operating guidelines, and process documentation.

• Develop and implement initiatives that improve team efficiency, productivity, customer experience, and operational performance.
• Oversee change management activities and support successful implementation and adoption of new processes, systems, and business solutions.
• Provides 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.

• College graduate of any course
• With at least five (5) years’ experience in managing the claims team and with a strong track record in achieving company targets
• Strong analytical skills with high attention to detail and accuracy
• Proficient in the use of MS Office applications and other business application systems for reporting and daily transaction handling
• With excellent written and oral communication skills in both English and Filipino.

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.