Senior Claim Officer

Job Summary

The Senior Claim Officer is responsible for managing and overseeing claim administration processes to ensure timely, accurate, and compliant claim handling. The role involves reviewing claim documentation, assessing eligibility, coordinating with internal and external stakeholders, preparing claim reports, and supporting risk management activities. The position also contributes to process improvements and ensures high standards of customer service and operational efficiency.

Key Responsibilities

• Review, evaluate, and process claims in accordance with organizational policies and procedures
• Verify claim documentation and ensure completeness and accuracy of submitted records
• Investigate claims and identify discrepancies, risks, or unusual transactions
• Coordinate with clients, service providers, and internal departments regarding claim requirements and resolutions
• Prepare claim assessments, recommendations, and approval documentation
• Maintain accurate records and ensure all claim files are properly documented and archived
• Monitor claim turnaround time and implement measures to improve service delivery
• Generate periodic claim performance and analytical reports for management review
• Support audits and ensure compliance with applicable regulations and company standards
• Provide guidance and technical support to junior claim officers
• Participate in process improvement initiatives to strengthen claims management systems
• Handle escalated or complex claims and provide appropriate recommendations

Education

• BSc/BA Degree in Accounting, Management, Economics, Statistics, Mathematics, Management, or related fields from a recognized institution

Experience

• Minimum of 5 years of relevant work experience
• At least 2 years of experience serving as Claim Officer II or in an equivalent position

Required Skills & Competencies

• Strong analytical and problem-solving abilities
• Good understanding of claims processing procedures and documentation standards
• Excellent attention to detail and numerical accuracy
• Strong report writing and record management skills
• Effective communication and stakeholder management abilities
• Proficiency in Microsoft Office applications and claims-related systems
• Ability to work under pressure and manage multiple priorities
• High level of integrity, confidentiality, and professional ethics

Skills Required:

• Accounting / Finance
• Economics / Statistics
• Sales / Marketing / Business / Management