Claims Operations Supervisor (U.S. Healthcare Claims)

About the role

We are seeking a Claims Operations Supervisor to lead U.S. healthcare claims operations in our Makati office. The role focuses on driving team performance, quality, service levels, and continuous improvement in a fast‑paced, metrics‑driven environment.

Key responsibilities

• Lead daily claims operations to meet accuracy, productivity, quality, and service‑level goals.
• Manage team performance through coaching, performance monitoring, and issue resolution.
• Partner with training and QA teams to strengthen onboarding, refresher training, accuracy, and consistency.
• Handle client or stakeholder communication, escalations, and operational updates professionally and timely.
• Provide regular business updates on team performance, quality, service levels, and improvement actions.
• Drive continuous‑improvement initiatives to reduce errors, delays, and rework.
• Ensure adherence to operational processes, controls, and compliance requirements.
• Collaborate with cross‑functional teams such as QA, training, workforce management, HR, and client services.

Required profile

• 4+ years of experience in U.S. healthcare claims processing, adjudication, or revenue‑cycle management.
• 2+ years of team leadership experience overseeing 20‑30 claim examiners.
• Strong understanding of claims workflows, medical terminology, coding concepts, benefits, and payer/provider processes.
• Proven ability to manage productivity, quality, service levels, and team performance in a metric‑driven environment.
• Excellent written and verbal communication skills for client, stakeholder, and internal discussions.
• Analytical and problem‑solving capabilities.

Required skills