Claims Operations Lead: Facets & BPM Expert

UST; Taguig; On-site; PHP 1,800,000 - 2,800,000; Full time

Job summary

UST seeks a Claims Lead to oversee end-to-end claims operations in a BPM setting for a U.S. healthcare payer. You will manage governance, performance metrics, and workforce delivery in a Facets-driven environment.

Ideal candidates have 8+ years in U.S. Healthcare Claims Operations and 2+ years in a team lead role, with strong leadership and analytic skills to drive continuous improvements and offshore delivery success.

Qualifications

• 8+ years of experience in U.S. healthcare claims operations.
• 2+ years in a team lead or operations lead role.
• Strong Facets expertise is required.
• Experience with offshore delivery models is a plus.

Responsibilities

• Lead end-to-end claims delivery within the Facets adjudication environment.
• Manage daily production, workload balancing, and throughput across queues.
• Ensure adherence to KPIs, SLAs, and productivity targets.
• Drive governance, quality, and process improvements in claims operations.

Skills

Facets expertise

Leadership

Claims operations

Governance

Process improvement

Communication

Job description

UST seeks a Claims Lead to oversee end-to-end claims operations in a BPM setting for a U.S. healthcare payer. You will manage governance, performance metrics, and workforce delivery in a Facets-driven environment.

Ideal candidates have 8+ years in U.S. Healthcare Claims Operations and 2+ years in a team lead role, with strong leadership and analytic skills to drive continuous improvements and offshore delivery success.