{"id":2239658,"url":"https://alion.io/job/nestle-operational-risk-specialist","title":"Operational Risk Specialist","company":{"id":447067,"name":"Nestlé","domain":"nestle.com","url":"https://alion.io/company/nestle-7","size_band":"5000+","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Career sitemap","truth_index":{"grade":"A","score":100,"open_postings":15,"ghost_share":0,"stale_share":0.067,"repost_share":0,"time_to_fill_p50_days":15,"computed_at":"2026-10-21T05:46:15Z"}},"role":"Finance","role_family":"Finance","seniority":"junior","employment_type":null,"work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Meycauayan, Philippines"],"countries":["PH"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":{"min_usd":7500,"max_usd":15500,"period":"year","method":"role_seniority_country_remote_cell","sample_n":9},"experience_years_min":2,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Office","optional":false}],"status":"live","first_seen_at":"2026-10-02T00:00:00Z","employer_posted_date":"2026-10-02","last_verified_at":"2026-10-22T02:27:27Z","board_verified":true,"closed_at":null,"days_open":20,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":20},"description":"Location: Meycauayan, Bulacan, PH\nCompany: Nestlé Integrated Business Services Manila, Inc.\nJob Type: Full Time\nEducation: Bachelor’s Degree (Medical-related course preferred)\nExperience: At least 2+ years of experience in medical, healthcare, or BPO environment\nJoining Nestlé means being part of the largest food and beverage company in the world, driven by a purpose to enhance quality of life and contribute to a healthier future.\nNestlé Integrated Business Services Manila, Inc. delivers world-class business support across global markets, with a strong focus on accuracy, efficiency, and service excellence.\nAs a Medical Risk Specialist, you will support the delivery of medical insurance and risk management services across markets. You will play a critical role in medical claims processing, insurance analysis, and stakeholder coordination, ensuring accuracy, compliance, and timely resolution of insurance-related activities.\nYou will collaborate closely with Group Risk Services (GRS), Total Rewards, and external insurance providers to drive operational excellence and continuous improvements in medical insurance processes.\nA Day in the Life\nAnalyze medical claims, billing, and coding data to ensure accuracy and completeness of insurance processes\nManage and process medical insurance claims, including validation, documentation, and follow-ups with insurers\nCoordinate with internal stakeholders and external partners (insurers, brokers, third-party administrators) to resolve issues and escalations\nMaintain and validate employee census data aligned with insurance policies and agreements\nPrepare reports on claims utilization, trends, and risk insights to support decision-making\nSupport governance, compliance, and internal control activities in relation to medical insurance\nDrive process improvements and automation initiatives to enhance efficiency and service delivery\nConduct regular reviews, stakeholder discussions, and knowledge-sharing sessions\nKey Responsibilities\nEnsure accurate and timely claims processing and reporting\nManage and resolve insurance-related queries and escalations\nMaintain high-quality medical data management standards\nSupport risk analysis, compliance, and governance frameworks\nDeliver insights through data analysis and reporting\nContribute to continuous improvement and stakeholder satisfaction\nQualifications & Skills\nBachelor’s degree in Nursing, Medical Technology, Psychology, or related field\nMinimum of 2 years’ experience in healthcare, medical insurance, or BPO setting\nKnowledge of medical insurance processes, claims handling, and coding\nProficiency in MS Office (Excel, Word) and familiarity with SAP systems\nExperience in data analysis, reporting, and database management\nUnderstanding of risk management, compliance, and internal controls\nLocation: Meycauayan, Bulacan, PH\nCompany: Nestlé Integrated Business Services Manila, Inc.\nJob Type: Full Time\nEducation: Bachelor’s Degree (Medical-related course preferred)\nExperience: At least 2+ years of experience in medical, healthcare, or BPO environment\nJoining Nestlé means being part of the largest food and beverage company in the world, driven by a purpose to enhance quality of life and contribute to a healthier future.\nNestlé Integrated Business Services Manila, Inc. delivers world-class business support across global markets, with a strong focus on accuracy, efficiency, and service excellence.\nAs a Medical Risk Specialist, you will support the delivery of medical insurance and risk management services across markets. You will play a critical role in medical claims processing, insurance analysis, and stakeholder coordination, ensuring accuracy, compliance, and timely resolution of insurance-related activities.\nYou will collaborate closely with Group Risk Services (GRS), Total Rewards, and external insurance providers to drive operational excellence and continuous improvements in medical insurance processes.\nA Day in the Life\nAnalyze medical claims, billing, and coding data to ensure accuracy and completeness of insurance processes\nManage and process medical insurance claims, including validation, documentation, and follow-ups with insurers\nCoordinate with internal stakeholders and external partners (insurers, brokers, third-party administrators) to resolve issues and escalations\nMaintain and validate employee census data aligned with insurance policies and agreements\nPrepare reports on claims utilization, trends, and risk insights to support decision-making\nSupport governance, compliance, 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