Claims Officer

(for a Unilab Group Subsidiary)

It is the spirit of Bayanihan that drives us to continue our legacyof excellence and commitment to care. As an organization we achieve our successes through good honest and persevering hard work - TOGETHER. It is in this way in which our company was built; we progressed as the countrys leading Pharmaceutical company not by sheer luck but by pure perseverance integrity and brotherhood. Grow with us and be a part of the Bayanihan spirit.

Bonifacio Insurance Broker Corporation (BIBC) was incorporated on May 7 1998 and registered with the Philippine Securities and Exchange Commission (SEC) under SEC Registration No. A. The company is engaged in insurance brokering services covering all lines of property and casualty insurance surety bonds life and medical insurance and all other related lines and services.

BIBC is an affiliate of United Laboratories Inc. A group which prides itself in providing trusted and quality healthcare products and services to its customers.

Job Summary

The Claims Officer is responsible for overseeing day-to-day claims operations ensuring that all client claimsregardless of insurance lineare 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

• Bachelors degree in Business Administration Management or a related business course.
• At least 5 years of experience in insurance claims processing with 12 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.

We are committed to providing our employees with the best possible experience. As a LEARNING ORGANIZATION we are eager to support your development and create the most fitting career path for you. As DESIGNERS AND DRIVERS OF INNOVATION we are keen to provide you with opportunities to positively transform processes that will intensify business growth. As a NURTURING FAMILY we are passionate about conducting programs that can promote your wellness and help you be the best that you can be. As BELIEVERS OF OUR PURPOSE we are and we will always remain earnest in giving meaningful tasks that will keep you delighted and fulfilled - at work and beyond.