Job Description - Accounting Assistant - Claims Payment

Functions (Duties and Responsibilities)

Claims Payment Processing

  • Verification: Verify and validate claim settlement amounts against approved claims and policy terms.
  • Payment Execution: Prepare and release payments via bank transfer, check, EFT, or other approved methods.
  • SLA Adherence: Ensure payments are processed within agreed Service Level Agreements (SLAs) and regulatory timelines.

Reconciliation & Accounting

  • Account Reconciliation: Perform daily reconciliation of claims payment accounts.
  • Ledger Entries: Accurately record all payments in the general ledger and insurance core system.
  • Financial Closing: Support month-end, quarter-end, and year-end closing activities for claims provisions.

Compliance & Risk Control

  • Regulatory Compliance: Ensure full compliance with Insurance Commission (IC) regulations, tax requirements, and company policies.
  • Fraud Prevention: Conduct payee verification and due diligence to prevent fraud and duplicate payments.
  • Escalation: Identify and escalate suspicious or irregular claims for further review.

Documentation & Reporting

  • Record Keeping: Maintain complete and accurate supporting documentation for all payments.
  • Reporting: Prepare daily, weekly, and monthly claims payment reports and performance dashboards.
  • Audit Support: Support internal, external, and regulatory audits.

Stakeholder Management

  • Cross-Functional Coordination: Coordinate with Claims, Underwriting, Legal, and Operations teams on payment-related matters.
  • Bank Relations: Liaise with banks and payment providers to resolve rejected or failed transactions.

Process Improvement

  • Automation: Identify opportunities to automate and streamline the claims payment process.
  • Digital Initiatives: Participate in system enhancement and digital transformation initiatives.

Qualifications & Experience

  • Education: Bachelor's degree in Accountancy, Finance, Business Administration, or a related field.
  • Certification: CPA license (or progress toward a CPA designation) is an advantage.
  • Experience: Minimum 2–5 years of relevant experience in claims payment, accounts payable, or insurance finance.
  • Technical Skills: Experience with insurance core systems is highly preferred.
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