Claims Officer

Bonifacio Insurance Broker Corporation; Mandaluyong; On-site; PHP 360,000 - 600,000; Full time

Benefits offered by this job

Dental

Optical Allowance

Hospitalization limit for employees

Outpatient Benefits

Maternity Coverage

Medical Reimbursement

Rice Allowance

Meal Subsidy

Clothing Allowance

Transportation Allowance

Retirement Plan

Life and Personal Accident Insurance

Discounted Medicine Vale of Unilab

Job summary

Bonifacio Insurance Broker Corporation is seeking a Claims Officer to oversee daily claims operations across life and general lines, ensuring accuracy, speed, and regulatory compliance. You will coordinate with insurers, clients, and internal teams to secure fair settlements and timely updates.

The role requires 5+ years in claims processing with supervisory experience, strong knowledge of insurance products, and proficiency with claims management software.

Qualifications

• Bachelor’s degree in Business Administration, Management, or a related business course.
• At least 5 years of experience in insurance claims processing, with 1-2 years in a supervisory role.
• Strong knowledge of life and general insurance products, claims processes, and regulatory requirements.
• Experience with claims management systems and related software.

Responsibilities

• Coordinate with insurers and clients to resolve claims promptly.
• Ensure insurer decision complies with policy terms and conditions.
• Monitor claim status and provide timely updates to clients and stakeholders.
• Assess the validity of claims through information gathering and evaluation.
• Negotiate settlements and ex gratia payments as needed.
• Lead and mentor the claims staff to improve performance and efficiency.
• Conduct performance reviews and maintain high morale.
• Collaborate with account management and stakeholders to aid in claim resolution.
• Act as escalation point for complex or high-priority claims.
• Ensure compliance with regulatory requirements and company policies.
• Conduct audits and quality checks to identify errors or areas for improvement.
• Prepare accurate documentation for claims and compliance reporting.
• Lead efforts to settle claims efficiently within timelines.
• Analyze claims data to identify trends and opportunities for improvement.
• Propose and implement process enhancements to streamline the claims process.
• Prepare regular claims performance reports for brokerage management.

Skills

Leadership

Analytical thinking

Communication

Attention to detail

High-pressure handling

Education

Bachelor's degree in Business Administration/Management or related

Tools

Claims management software

Job description

Job Summary

The Claims Officer is responsible for overseeing day-to-day claims operations, ensuring that all client claims—regardless of insurance line—are processed accurately, promptly, and in compliance with regulatory and company standards. This role also serves as the escalation point for complex issues and coordinates closely with insurers, internal teams, and clients to support timely and fair claims resolution. The position plays a critical role in maintaining service excellence, driving process improvement, and strengthening team performance.

Key Responsibilities

Claims Management

Coordinates with insurers and clients to ensure timely resolution of insurance claims.

Ensures that the claims decision of the insurer is fair and adheres to the insurance policy contract coverage, terms and conditions.

Monitors the status of claims and ensures timely updates to clients and stakeholders.

Assesses the validity of insurance claims through gathering and evaluation of relevant information.

Negotiates claim settlements and requests for ex gratia settlements, as reasonably necessary.

Collaboration and Team Supervision

Leads and mentors the claims staff, providing training and guidance to improve performance and efficiency.

Conducts performance reviews and ensures high standards of productivity and morale.

Closely collaborates with the account management team, customers, and other stakeholders to obtain information to aid in insurance claim resolution.

Customer Service

Acts as the escalation point for complex or high-priority claims, resolving disputes or complaints in a professional manner.

Collaborates with clients and insurance providers to address inquiries and ensure a smooth claims experience.

Compliance, Reporting, Process Improvement, and Quality Assurance

Ensures all claims processes adhere to regulatory requirements and company policies.

Conducts audits and quality checks to identify errors, inconsistencies, or areas for improvement.

Prepares and maintains accurate documentation for claims and compliance reporting.

Takes the lead in ensuring that claims are settled efficiently within established timelines and guidelines.

Analyzes claims data to identify trends, risks, and opportunities for process or service improvement.

Recommends and helps implement operational enhancements to streamline the claims process.

Prepares regular reports on claims performance and key metrics for the brokerage.

Qualifications

Bachelor’s degree in Business Administration, Management, or a related business course.

At least 5 years of experience in insurance claims processing, with 1-2 years in a supervisory role.

Strong knowledge of life and general insurance products, claims processes, and regulatory requirements.

Experience with claims management systems and related software.

Skills and Competencies

Excellent leadership and team management skills.

Strong analytical and decision-making abilities.

Exceptional communication and interpersonal skills.

High attention to detail and commitment to accuracy.

Ability to handle complex and high-pressure situations effectively.

Benefits:

• Dental

• Optical Allowance

• Hospitalization limit for employees and dependents

• Outpatient Benefits

• Maternity Coverage

• Medical Reimbursement

• Rice Allowance

• Meal Subsidy

• Clothing Allowance

• Transportation Allowance

• Retirement Plan

• Life and Personal Accident Insurance

• Discounted Medicine Vale of Unilab Products