Claims Officer

About the role

The Claims Officer oversees daily claims operations for a leading Philippine insurance broker, ensuring accurate, timely, and compliant processing of client claims across all insurance lines. This role serves as the escalation point for complex issues and works closely with insurers, internal teams, and clients to achieve fair resolutions.

Key responsibilities

• Coordinate with insurers and clients to ensure timely resolution of insurance claims.
• Verify that claim decisions are fair and adhere to policy terms and conditions.
• Monitor claim status and provide regular updates to stakeholders.
• Assess claim validity by gathering and evaluating relevant information.
• Negotiate settlements and ex gratia requests as needed.
• Lead, mentor, and train claims staff, conducting performance reviews.
• Collaborate with account management, customers, and other stakeholders to obtain information for claim resolution.
• Act as escalation point for high‑priority or disputed claims, handling complaints professionally.
• Ensure compliance with regulatory requirements and company policies.
• Conduct audits, quality checks, and identify process improvement opportunities.

Required profile

• Proven experience in claims management within insurance or related sectors.
• Strong leadership and team‑development abilities.
• Excellent communication and negotiation skills.
• Detail‑oriented with a focus on regulatory compliance.

Required skills