Claims Processing Manager

About the role

The Claims Processing Manager leads the regional health claims unit, acting as the operational bridge between global management and the local processing team. This senior leader drives productivity, shapes departmental strategy, and ensures service delivery exceeds client expectations.

Key responsibilities

• Lead a team of claims adjusters to meet departmental KPIs and organizational goals.
• Serve as liaison between Global Management and the claims team, ensuring clear communication and alignment.
• Develop and implement departmental strategies, goals, and policies.
• Prepare and present regular performance, claims activity, and KPI reports to Regional Management.
• Review complex or escalated claims, provide determinations, and resolve customer complaints.
• Analyze claims data to identify trends, drive process improvements, and support strategic decisions.

Required profile

• Bachelor’s degree in a relevant field such as medical, finance, business administration, or insurance.
• Minimum 8 years of progressive experience in claims management, TPA, or health insurance operations.
• At least 4 years in a supervisory or management role with a proven track record.
• Strong analytical abilities to interpret data, detect inefficiencies, and make data‑driven decisions.
• Excellent organizational and project‑management skills, able to handle multiple priorities in a fast‑paced environment.

Required skills

• Proficiency with claims management software.
• Advanced knowledge of Microsoft Office Suite.