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.