Corporate Claims Officer- JLIL 408

Main Responsibilities

Strategy

• Support implementation of the corporate claims strategy through efficient execution of day-to-day claims operations.
• Contribute to continuous improvement initiatives aimed at enhancing claims processes, turnaround times, and customer experience.
• Provide feedback and operational insights on claims trends, challenges, and service improvement opportunities.

Operational

• Process end-to-end corporate claims, including claim registration, assessment, verification, adjudication and settlement within defined turnaround times.
• Review claims documentation to ensure completeness, accuracy, and compliance with policy terms and conditions.
• Verify claims eligibility and assess claims in line with delegated authority limits and company guidelines.
• Escalate complex, suspicious, or high-value claims to the Team Leader or Manager where necessary.
• Maintain accurate and updated claims records within the system and ensure proper filing of supporting documentation.
• Follow up on outstanding requirements with clients, brokers, medical providers, and other stakeholders to facilitate timely claims resolution.
• Prepare claims correspondence and communicate claim decisions, requirements, and updates to stakeholders professionally and promptly.
• Support reconciliation and payment processing by coordinating with finance and other relevant departments.
• Monitor and manage individual claims workload to ensure adherence to service level agreements and operational targets.
• Assist in preparation of claims reports, statistics, and operational updates as required.

Claims Quality & Risk Management

• Ensure claims are processed in accordance with policy provisions, underwriting guidelines, and regulatory requirements.
• Maintain high levels of accuracy and quality in claims assessment and documentation.
• Identify and escalate suspicious or potentially fraudulent claims for further investigation.
• Adhere to internal controls, risk management frameworks, and operational procedures within the claims process.
• Support implementation of corrective actions arising from audits, quality reviews, or compliance assessments.

Customer Experience

• Provide timely, professional, and empathetic support to corporate clients, brokers, beneficiaries, and other stakeholders.
• Respond to claims inquiries, complaints, and follow-ups within defined timelines.
• Maintain regular communication with stakeholders regarding claims progress and outstanding requirements.
• Support initiatives aimed at improving customer satisfaction and strengthening service delivery standards.

Corporate Governance

• Ensure compliance with all applicable regulatory, statutory, and internal policies governing claims management.
• Maintain proper claims documentation and audit trials for all processed claims.
• Adhere to company policies, procedures, and risk management requirements.
• Support internal and external audit processes by providing required documentation and information.

People & Culture

• Cross-Functional Collaboration: Actively participate in cross-functional project teams to drive collaboration, innovation, and accountability across departments and the Group.
• Employee Collaboration Index: Participate in a minimum of 2 company projects per year with an 80% success rate and engage in at least 1 Group-wide project per year.
• Skills and Competency Development Index: 100% compliance with your training plan annually to support personal and professional growth, ensuring alignment with career paths and future challenges.
• Cultural Alignment Index (CAI): Attain the Company’s CAI target score by embedding Jubilee’s values (e.g., innovation, teamwork, excellence) into project execution and team dynamics.
• Conflict Resolution: Address interpersonal or project-related conflicts constructively, maintaining team morale and focus on shared goals.
• Resource Advocacy: Communicate needs (e.g., tools, training, support) to supervisors to ensure personal and team success.

Key Competencies

• Customer Centricity – Ability to provide quality service and effectively manage stakeholder expectations.
• Analytical & Problem-Solving Skills – Ability to assess claims, identify issues, and recommend solutions.
• Attention to Detail – High level of accuracy in claims review and documentation.
• Risk & Compliance Awareness – Understanding of operational controls and regulatory requirements.
• Communication & Interpersonal Skills – Ability to communicate effectively with internal and external stakeholders.
• Time Management & Organization – Ability to manage workload efficiently and meet deadlines.
• Teamwork & Collaboration – Ability to work collaboratively across departments and support team objectives.
• Professionalism & Integrity – Ability to handle confidential information responsibly and ethically.

Academic Background & Relevant Qualifications

• Bachelor’s Degree in Insurance, Business Administration, Finance, or related field
• Diploma in Insurance
• Professional qualification (LOMA, CII, IIK)
• Minimum of 2–3 years of experience in insurance claims administration, preferably within Group Life.
• Experience in claims assessment, documentation review and claims processing.
• Exposure to customer service and stakeholder engagement within an insurance environment.
• Experience in handling claims queries, follow-ups and escalations.
• Familiarity with claims quality assurance, compliance and operational controls is an added advantage.