MEDICAL CLAIMS TEAM LEAD

We are looking for a detail-oriented, analytical, and service- driven Claims Adjudication Team Lead to oversee the daily operations of our Claims Adjudication Unit.

This role is ideal for someone with strong claims processing expertise who enjoys leading a team, improving workflows, and ensuring timely and accurate claims adjudication

• LEVEL: Supervisor
• Deployment: Medical Division (Pacific Cross)
• Work Location & Schedule: Rockwell, Makati | 8:00 to 5:00 Mon-Fri

Your Role:

• Supervise and support Claims Adjudicators handling availment and reimbursement claims

• Monitor productivity, accuracy, and turnaround times to meet service level targets

• Review complex or escalated claims within approved authority limits

• Conduct claim audits and investigations to identify processing issues and discrepancies

• Ensure compliance with cl...