JOB PURPOSE
Holds a specialized role in handling complex insurance policy transactions, providing interdepartmental consultation, and contributing to process standardization. This position plays a key part in system improvement initiatives and elevates the technical capabilities of the entire Policy Service function.
KEY ACCOUNTABILITIES
Key Accountabilities (1)
Specialized Policy Operations
• Handle high- complexity cases including premium frequency adjustments, product conversions with unique benefit features, and disputed beneficiary updates.
• Analyze operational data from returned cases, reinstatements, and policy cancellations to recommend improvements in servicing protocols.
• Collaborate with Legal, Reinsurance, or Corporate Client teams in cases involving legal intricacies, sensitive transactions, or systemic impact.
• Support development of internal audit mechanisms for high- risk or high- value cases to safeguard accuracy and operational integrity.
• Lead resolution for sensitive file scenarios such as benefit disputes, inconsistent beneficiary data, or potential customer complaints.
• Contribute to policy segmentation standards based on complexity, product line, and policy value to optimize workflow structure.
• Provide technical input in cross- functional discussions involving policy servicing updates, processing guideline revisions, or system enhancements.
• Advise frontline teams on verification methods, case handling approaches, and tailored customer communications for nuanced situations.
• Conduct thorough file checks to verify validity and completeness, and provide expert reviews for exception scenarios.
Key Accountabilities (2)
Cross- functional Collaboration and Organizational Capability Development
• Foster a “quality- driven culture” within the Policy Service department through mentoring, real- case sharing, and internal technical critique.
• Act as a senior technical liaison for Policy Service in collaborating with key departments such as Product, Legal, Reinsurance, Corporate Client and IT, particularly for legally sensitive or systemic- impact policy cases.
• Propose control and triage frameworks for complex transactions and support the design of collaboration models between operational and support teams.
• Provide expert guidance to senior specialists and frontline staff in resolving complex cases such as beneficiary updates, benefit alterations, or reinstatements with special conditions.
• Advise HR on Policy Service workforce development planning, including role distribution, collaboration structures, and career progression criteria.
• Participate in cross- functional initiatives to enhance policy service workflows, upgrade system functionalities, or revise approval structures for high- value cases.
• Represent Policy Service in product design sessions or in policy impact reviews related to system upgrades, business rule changes, or SLA adjustments.
• Assist in developing advanced training programs for senior policy staff, covering complex case analysis, regulatory updates, and customer communication standards. Contribute to the creation of a specialized competency framework for the Policy Service function, defining skill, knowledge and behavior expectations per career level.
• Collaborate in building tools and instructional materials to help frontline teams deliver first- pass accuracy on policy servicing tasks.
Key Accountabilities (3)
Quality Assurance and Process Innovation
• Help design real- time quality dashboards for policy servicing files, integrating QA metrics, feedback loops, and team performance indicators.
• Advise management on operational loss control strategy by identifying critical control points and flagging high- risk transaction tiers for enhanced supervision.
• Promote a culture of “first- pass accuracy” through technical documentation, coaching initiatives, and multi- angle feedback mechanisms.
• Share representative cases involving sensitive data, atypical errors, or rare exceptions to raise risk awareness and build team responsiveness.
• Conduct periodic reviews of frontline and complex policy files to assess accuracy, procedural compliance, and data consistency across systems.
• Perform in- depth analysis of common operational errors—e.g. incorrect system input, missing required documents, format template inconsistencies—and build remediation guides and flow- based control tools.
• Participate in Policy Service process improvement groups, evaluating proposed changes from other departments based on operational feasibility and risk exposure. Recommend automated system control configurations (e.g. entry alerts, approval prompts, input format checks) to enhance processing reliability.
• Contribute to the development of quality control standards segmented by product type, transaction category, and risk level to support input/output verification and staff training. Identify systemic deviation patterns such as high rejection rates in specific products or error- prone teams and recommend targeted improvement actions.
