Operations Manager (Claims)

QBE Group Shared Services Centre; Cebu City; On-site; PHP 1,200,000 - 2,000,000; Full time

Job summary

QBE Group Shared Services Centre is seeking an experienced Claims Operations Lead to oversee the operational and technical aspects of the team, ensuring efficient claims handling and continuous improvement. You will build strong relationships with internal stakeholders and customers while driving quality and service excellence.

The role requires significant experience in claims management and staff leadership across locations, with a focus on process optimization and regulatory compliance.

Qualifications

• Necessary tertiary degree or equivalent combination of education and work experience.
• Experience in claims management or leadership roles is preferred.
• Strong ability to manage stakeholder relationships and drive process improvements.

Responsibilities

• Establish methods and procedures to manage, supervise, and direct the claims operations in a cost-effective manner
• Set department goals and policies in conjunction with business plans to ensure objectives are met
• Identify, analyze, recommend and implement process improvements in functional areas
• Achieve specific key performance indicators and strive to improve overall service delivery
• Act as a critical point of escalation on complex, denied or pending claims
• Maintain current knowledge of products and services to provide direction and respond to issues
• Cultivate positive relationships with internal and external customers to accomplish organizational goals
• Assess present and future resource needs for employees and provide leadership, mentoring and guidance
• Manage budgeted resources by forecasting costs and ensuring fiscal responsibility

Skills

Adaptability

Claims Settlement

Critical Thinking

Data Management

Insurance Claims Management

Insurance Claims Processing

Intentional collaboration

Managing performance

Negotiation

Personal Initiative

Presenting with Impact

Regulatory Compliance

Risk Management

Sound Judgment

Stakeholder Management

Education

Bachelor's degree or equivalent

Job description

Primary Details

Time Type: Full time

Worker Type: Employee

The purpose of this role is to oversee the operational and technical aspects of the team, ensuring efficient claims handling through best practices. This role involves driving continuous improvement initiatives to enhance quality and service while building strong relationships with both internal stakeholders and customers.

Responsibilities

• Establish methods and procedures to manage, supervise, and direct the claims operations in a cost-effective manner
• Set department goals and policies in conjunction with business plans to ensure objectives are met
• Identify, analyze, recommend and implement process improvements in functional areas
• Achieve specific key performance indicators and strive to find better ways to improve overall service delivery
• Act as a critical point of escalation on complex, denied or pending claims
• Maintain current knowledge of products and services to provide direction and respond to issues
• Cultivate positive relationships with internal and external customers to accomplish organizational goals
• Assess present and future resource needs for employees and provide the leadership, mentoring and guidance necessary to build and sustain a high performing workforce
• Manage budgeted resources by anticipating expenditures, accurately forecasting resource needs/costs and properly accounting for expenses to meet requirements and achieve fiscal responsibility

Work Experience

Necessary Work Experience includes:

• Significant relevant experience.

Preferred Work Experience includes:

• Management experience with claims management.
• Experience managing claims teams across multiple locations.
• Legal or long tail claims experience.
• Experience managing remote teams.

Qualifications

Necessary Qualifications include:

• Tertiary Degree or equivalent combination of education and work experience.

Global Disclaimer

The duties listed in this job description do not limit the assignment of work. They are not to be construed as a complete list of the duties normally to be performed in the position or those occasionally assigned outside an employee’s normal duties. Our Group Code of Ethics and Conduct addresses the responsibilities we all have at QBE to our company, to each other and to our customers, suppliers, communities and governments. It provides clear guidance to help us to make good judgement calls.

US Only Disclaimer

To successfully perform this job, the individual must be able to perform each essential job responsibility satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities.

US Only - Travel Frequency

Occasional (approximately 5-10 trips annually)

US Only - Physical Demands

General office jobs: Work is generally performed in an office environment in which there is not substantial exposure to adverse environmental conditions. Must have the ability to remain in a stationary position for extended periods of time. Must be able to operate basic office equipment including telephone, headset and computer. Incumbent must be able to lift basic office equipment up to 20 lbs.

Skills

Adaptability, Claims Settlement, Critical Thinking, Data Management, Insurance Claims Management, Insurance Claims Processing, Intentional collaboration, Managing performance, Negotiation, Personal Initiative, Presenting with Impact, Regulatory Compliance, Risk Management, Sound Judgment, Stakeholder Management

Equal Employment Opportunity

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.