Claims Clerk Full Time NEW

Job Posting

FOR THE POSITION OF

Claims Clerk

INSURANCE OPERATIONS DEPARTMENT

Purpose of the Role: To process insurance claims, traditional policy requests and related transactions accurately and efficiently, while delivering high-quality service within the Insurance Operations function.

Key Duties and Responsibilities

 Timely processing, recording and dispatch of death claims, policy rider claims, traditional policy calculations, traditional policy changes and maturities.

 Receive, review and validate claims documentation to ensure required forms, supporting evidence, approvals and customer information are complete before processing.

 Liaise with the reinsurance team as required to ensure applicable reinsurance requirements are identified and satisfied, provide relevant claims information and supporting documentation, address queries or outstanding requirements, and support the timely settlement and recovery of reinsured claims.

 Interact professionally with agents, policyholders, beneficiaries, claimants, support staff, internal auditors, financial institutions, medical professionals, service providers and other internal and external stakeholders, as required.

 Maintain complete, accurate and up-to-date records of claim transactions, requests, correspondence and actions taken.

 Complete MAV calculations where applicable, ensuring calculations are accurate, properly documented and submitted for review or approval in accordance with departmental procedures.

 Prepare and complete routine reports and status updates within established timelines as requested by the Manager, Supervisor or other established reporting lines.

 Identify inconsistencies, red flags or potentially fraudulent activity during the claims process and promptly refer concerns to the Supervisor or appropriate internal party.

 Maintain strict confidentiality and safeguard customer, policyholder and company information at all times.

 Other related duties that are reasonably assigned to support the smooth and effective operation of the department.

Qualifications and Experience:

 Proficiency in Microsoft Office applications.

 Experience in insurance claims, customer service or related fields.

 LOMA certification or other insurance related studies.

Any suitable combination of qualifications and experience will be considered.