Claims Manager
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Before you apply
LocationPhilippines - BGC Taguig
Typefull-time
SenioritySenior
Company size1,001–5,000 people
PostedSep 24, 2026 · 1mo ago
Verified live3d ago
At a glanceSummarised by Seekless from the posting.
Lead the end-to-end claims function
Manage a team of Claims Analysts and Claims Support staff
Serve as the technical authority for complex, contestable, escalated, and high-value claims involving Death, Critical Illness, Disability, Hospitalization, Waiver of Premium, and related benefits
Provide technical oversight on the assessment and adjudication of Death Claims
Provide technical oversight on the assessment and adjudication of Contestable and Incontestable Claims
Provide technical oversight on the assessment and adjudication of Critical Illness Claims
Provide technical oversight on the assessment and adjudication of Total and Permanent Disability Claims
Provide technical oversight on the assessment and adjudication of Waiver of Premium Claims
Provide technical oversight on the assessment and adjudication of Hospitalization and Medical Reimbursement Claims
Review and approve claims within delegated authority limits
Assess complex, high-exposure, contestable, fraudulent, or litigated claims
Evaluate medical, financial, occupational, legal, and investigative information to determine claim validity
Manage the end-to-end claims workflow from claim notification to benefit settlement
Ensure delivery of service level agreements (SLAs), turnaround times, and productivity targets
Monitor claim inventories, aging reports, pending requirements, and backlog management
Drive operational excellence initiatives to improve efficiency, quality, and customer outcomes
Analyze claims data, trends, and operational metrics to identify opportunities for improvement
Oversee vendor relationships involving investigators, medical reviewers, legal counsel, and third-party service providers
Ensure proper documentation and maintenance of claim records and audit trails
About FWD Group
FWD Group (1828.HK) is a pan-Asian life and health insurance business that serves approximately 40 million customers across 10 markets, including BRI Life in Indonesia. FWD’s customer-led and tech-enabled approach aims to deliver innovative propositions, easy-to-understand products and a simpler insurance experience. Established in 2013, the company operates in some of the fastest-growing insurance markets in the world with a vision of changing the way people feel about insurance. FWD Group is listed on the main board of the Hong Kong Stock Exchange under the stock code 1828.
For more information, please visit www.fwd.com
About FWD Life Philippines
FWD Life Insurance Corporation (FWD Life Philippines) launched its commercial operations in September 2014. As of end-2022, FWD Life Philippines ranks 3rd and 6th in terms of Paid-up Capital(1) and New Business Annual Premium Equivalent(2), respectively.
For more information, please visit fwd.com.ph.
1 www.insurance.gov.ph > Statistics > Life > 2022 > Based on Paid-Up Capital
2 www.insurance.gov.ph > Statistics > Life > 2022 > Based on New Business Annual Premium Equivalent
About the role
The Claims Manager is responsible for leading the end-to-end claims function, ensuring fair, accurate, and timely adjudication of life and health insurance claims while delivering an exceptional customer experience. The role oversees technical claims assessment, claims operations, quality assurance, regulatory compliance, people leadership, and continuous process improvement.
The incumbent will manage a team of Claims Analysts and Claims Support staff and serve as the technical authority for complex, contestable, escalated, and high-value claims involving Death, Critical Illness, Disability, Hospitalization, Waiver of Premium, and related benefits. The role also drives operational efficiency, governance, risk management, and customer-centric claims practices. This aligns with internal claims approval, assessment, payment, QA, and escalation processes documented in your claims operations materials
Responsibilities
1.
Claims Adjudication and Technical Leadership
Provide technical oversight on the assessment and adjudication of:
•
Death Claims
•
Contestable and Incontestable Claims
•
Critical Illness Claims
•
Total and Permanent Disability Claims
•
Waiver of Premium Claims
•
Hospitalization and Medical Reimbursement Claims
Review and approve claims within delegated authority limits.
Assess complex, high-exposure, contestable, fraudulent, or litigated claims.
Evaluate medical, financial, occupational, legal, and investigative information to determine claim validity.
2.
Operations Management
Manage the end-to-end claims workflow from claim notification to benefit settlement.
Ensure delivery of service level agreements (SLAs), turnaround times, and productivity targets.
Monitor claim inventories, aging reports, pending requirements, and backlog management.
Drive operational excellence initiatives to improve efficiency, quality, and customer outcomes.
Analyze claims data, trends, and operational metrics to identify opportunities for improvement.
Oversee vendor relationships involving investigators, medical reviewers, legal counsel, and third-party service providers.
Ensure proper documentation and maintenance of claim records and audit trails.