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Claims Processing Manager

Nextcare

Senior 🇬🇧 English

Job description

About the role

The Claims Processing Manager leads the regional health claims unit, acting as the operational bridge between global/regional leadership and the local processing team. This senior role drives productivity, strategic direction, and high‑quality service delivery for complex health insurance claims.

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, policies, and procedures.
  • Prepare and present regular performance, metric, and trend 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.
  • Monitor workload distribution, ensure regulatory compliance, and mentor team members.
  • Participate in cross‑functional activities to coordinate service delivery and exceed client expectations.

Required profile

  • Bachelor’s degree in Medical/Paramedical, Finance, Business Administration, Insurance, or a related field (preferred).
  • Minimum 8 years of progressive experience in claims management, third‑party administration, or health insurance operations.
  • At least 4 years in a supervisory or leadership role.

Required skills

    What we offer

    • Leadership role within a dynamic, agile environment.
    • Opportunity to shape regional claims strategy and drive operational excellence.

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    Published 3 months ago

    25 views · 0 interested

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