Job Brief
This role oversees
claims registration and payment operations, ensuring timely, accurate, and compliant processing. It manages
vendors and TPAs, monitors SLAs, and leads
process improvement and digital transformation initiatives within claims operations.
Job Responsibilities
- Operational Excellence Claims Registration & Payment
- Provide end-to-end oversight of daily operations for Claims Registration and Payment to ensure accuracy, timeliness, and compliance with internal controls and policies.
- SLA & Quality Management: Establish, monitor, and continuously improve Key Performance Indicators (KPIs) and Service Level Agreements (SLAs) to ensure claims are registered and paid within stipulated turnaround times (TAT).
- Ensure strong financial governance, data integrity, and adherence to regulatory and audit requirements.
- Resource Optimization: Lead and supervise support teams, optimizing workforce capacity to manage fluctuating claim volumes effectively.
- Identify operational risks and implement mitigation controls to ensure service continuity and quality.
- Vendor & TPA Governance
- Performance Monitoring: Establish and manage a structured performance management framework for External Vendors and TPAs, focusing on service quality, SLA adherence, cost efficiency, and compliance.
- Agreement Management: Review vendor contracts and implement monthly tracking mechanisms to ensure all external partners uphold professional standards.
- Contract Review: Conduct regular reviews of External Vendors and TPAs agreements and implement a monthly tracking mechanism to monitor performance and compliance.
- Tender & Renewals: Manage the full end-to-end process for open tenders, new applications, or contract renewals for External Vendors and TPAs.
- Strategic Project Leadership
- Act as the project lead for Claims Transformation initiatives, focusing on automating manual workflows and integrating new technical capabilities (e.g., e-payments or digital registration).
- Identify gaps in the current claims journey and lead cross-functional projects to modernize the claims infrastructure.
- Process Innovation & Business Improvement
- Explore and implement new approaches to the business operating model to exceed customer expectations while ensuring a commercial return.
- Drive a continuous improvement culture by re-engineering workflows in the registration and ancillary services sections to optimize team capacity.
Qualifications & Experience
- Bachelor's degree in Business Administration, Finance, Insurance, Operations Management, or a related field.
- Minimum 710 years of experience in Claims Operations, Insurance Operations, or related functions, with proven leadership exposure.
- Strong experience managing Vendors and TPAs, including contract governance and performance management.
- Demonstrated experience leading operational transformation or digitalization projects.
- Knowledge of insurance claims processes, regulatory requirements, and SLA-driven environments.
Job Requirements
Qualifications & Experience
- Bachelor's degree in Business Administration, Finance, Insurance, Operations Management, or a related field.
- Minimum 710 years of experience in Claims Operations, Insurance Operations, or related functions, with proven leadership exposure.
- Strong experience managing Vendors and TPAs, including contract governance and performance management.
- Demonstrated experience leading operational transformation or digitalization projects.
- Knowledge of insurance claims processes, regulatory requirements, and SLA-driven environments.
Skills & Competencies
- Strong leadership and stakeholder management skills.
- Excellent analytical, problem-solving, and process improvement capabilities.
- Proven ability to manage complex operations with high attention to detail and governance.
- Strong project management skills with the ability to lead cross-functional initiatives.
- Clear communication skills and the ability to influence at multiple levels of the organization.
Diversity & Inclusion Commitment
The Company is committed to providing equal employment to all individuals regardless of their race, colour, religion, gender, sexual orientation, gender identity, national origin, age, disability, marital status or any other characteristic protected by applicable laws.
We try make sure everyone has a fair chance to work with us, no matter where they're from or who they are. We believe having different kinds of people on our team makes us better and more creative. Our friendly environment is all about treating every person with respect and making sure everyone's ideas count. We want people from all all walks of life to apply and be part of our mission to create a place where everyone is welcome and valued. 
