Applies subject matter expertise in compliance with the applicable laws and regulations, to define the organization's claims handling strategy and guidelines. Reviews the claims processing and settlement procedures to ensure their effectiveness, and recommends and drives improvements as necessary.

Develops and oversees the organization's claims processing and settlement procedures. Provides expertise in monitoring and evaluating the current methods and systems of claims payment handling. Recommends and justifies the need for new/improved methods and systems for payment processing and handling for complex claims.

Deeply understands the context and all aspects of claims settlement, processes claims and issues settlement document when appropriate and in accordance with the organization's claims processing procedures. Utilizes deep understanding of the techniques used for monitoring, reviewing and evaluating the claims payment processes, and investigates any payment discrepancies.

Understands the process of notifying policyholders with findings and regular updates regarding the progress and status of their claims. Builds on specialised knowledge and understanding of the various techniques used to resolve minor disputes around claims settlement, and when such techniques are used for non-routine claims.

Demonstrates basic understanding of the organization’s processes and procedures related to claims processing and settlement. Has basic knowledge of the identification of the key pieces of information required at the time of the notification of a claim, and is able to initiate simple communications and reports on routine claims.