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Senior Claim and Servicing Officer

Job Summary:

Senior Claim and Servicing Officer evaluate, investigate, and determine the validity of insurance claims against insurance policy. S/he collects information, conduct inspections, and consult with related parties to determine claims settlements with the clients and respond to claims enquiries.

Duties and Responsibilities:

  • Direct and supervise claims activities with representatives of partner institutions;
  • Conduct necessary investigations, validations and evaluations of claims filed;
  • Conduct continuing information dissemination in the area of coverage (Regular visits on the areas covered and regular visit to clients);
  • Consult with related parties such as lawyers, physicians, and other experts related to claims when needed;
  • Communicate and work on claims assessment and settlement with representatives of partner institutions to collect claim documents and information for claim investigation report;
  • Submit documents required for clams assessment as per the annexure1 to Sri Lankan team via either OASYS system or agreed systems;
  • Provide claims settlements in accordance with insurance policies to be effectively in accordance with the relevant regulations;
  • Promptly respond to client’s queries related to claims or advise clients of any concern regarding claim services;
  • Ensure the maintenance of appropriate recording and filing system of all claims;
  • Maintain current, completed, and accurate premium registers and other related underwriting records in the prescribed forms;
  • Find out the challenges, comments, and suggestions regarding our insurance services for improvement
  • Understand the company’s policies, procedures, internal rules and guideline;
  • Finding local partners with clinics, hospital, and garages, in order to provide simplify service for client needs around provinces.
  • Check the accuracy of monthly report submitted by branches against partner database;
  • Performs any other duties as assigned by supervisor.

Minimum Competencies Required

  • Bachelor Degree in Business or related field;
  • At least two years’ experience in claims
  • Strong analytical skills;
  • Good problem solving and complaint handling skill;
  • Good interpersonal and negotiation skills;
  • Integrity and hard-working;
  • Good command in English;
  • Willing to travel to work in the field/ provinces.